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Sample records for chronically ischemic myocardium

  1. Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR

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    Nagao Michinobu

    2012-02-01

    Full Text Available Abstract Background The purpose of this study was to quantify myocardial strain on the subendocardial and epicardial layers of the left ventricle (LV using tagged cardiovascular magnetic resonance (CMR and to investigate the transmural degree of contractile impairment in the chronic ischemic myocardium. Methods 3T tagged CMR was performed at rest in 12 patients with severe coronary artery disease who had been scheduled for coronary artery bypass grafting. Circumferential strain (C-strain at end-systole on subendocardial and epicardial layers was measured using the short-axis tagged images of the LV and available software (Intag; Osirix. The myocardial segment was divided into stenotic and non-stenotic segments by invasive coronary angiography, and ischemic and non-ischemic segments by stress myocardial perfusion scintigraphy. The difference in C-strain between the two groups was analyzed using the Mann-Whitney U-test. The diagnostic capability of C-strain was analyzed using receiver operating characteristics analysis. Results The absolute subendocardial C-strain was significantly lower for stenotic (-7.5 ± 12.6% than non-stenotic segment (-18.8 ± 10.2%, p Conclusions Analysis of tagged CMR can non-invasively demonstrate predominant impairment of subendocardial strain in the chronic ischemic myocardium at rest.

  2. Angiogenesis effects of adenovirus-mediated gene transfer of VEGF-B on chronic ischemic myocardium

    Institute of Scientific and Technical Information of China (English)

    DONG Shu-qiang; ZHANG Bao-ren; MEI Ju; XU Zhi-yun; ZOU Liang-jian; HUANG Sheng-dong

    2002-01-01

    Objective: To study the angiogenesis effects of adenovirus-mediated gene transfer of VEGF-B on chronic ischemic myocardium. Methods: Domestic pigs underwent thoracotomy and placement of an ameroid constrictor on the circumflex coronary artery. Four weeks later, Ad. VEGF-B, Ad. LacZ or PBS were administrated directly into the myocardium at 10 sites in the circumflex distribution (109 PFU or 100 μl) according to groups. Echocardiography and ex vivo coronary angiography were performed. The injection sites around myocardium were harvested and subjected to histological analysis and immunochemical staining. Results: Echocardiography assessment 4 weeks after vector administration demonstrated significant improvement of regional wall systolic function. Collateral vesseldevelopment assessed by angiography was also significantly greater in Ad. VEGF-B animals than that in control animals. Vascular density analysis revealed a mean of 43±5 neovessels per high-power field in Ad.VEGF-B group versus 19±4 and 17±6 in Ad.LacZ and PBS group. Conclusion:Direct intramyocardial administration of Ad.VEGF-B can induce focal angiogenesis and result in improvement in regional myocardial function, which may be useful in patients with ischemic heart disease who are not eligible for conventional therapies.

  3. Glucose metabolism in ischemic myocardium

    International Nuclear Information System (INIS)

    We determined the myocardial metabolic rate for glucose (MMRGlc) in the ischemic or infarcted myocardium using 18-F-fluorodeoxyglucose (18-FDG) with positron emission tomography (PET), and studied energy metabolism in the ischemic myocardium. In some cases, we compared glucose metabolism images by 18-FDG with myocardial blood flow images using 15-oxygen water. Two normal subjects, seven patients with myocardial infarction and four patients with angina pectoris were studied. Coronary angiography was performed within two weeks before or after the PET study to detect ischemic areas. PET studies were performed for patients who did not eat for 5 to 6 hours after breakfast. Cannulation was performed in the pedal artery to measure free fatty acid, blood sugar, and insulin. After recording the transmission scan for subsequent correction of photon attenuation, blood pool images were recorded for two min. after the inhalation of carbon monoxide (oxygen-15) which labeled the red blood cells in vivo. After 20 min., oxygen-15 water (15 to 20 mCi) was injected for dynamic scans, and flow images were obtained. Thirty min. after this procedure, 18-FDG (5 to 6 mCi) was injected, and 60 min later, a static scan was performed and glucose metabolism images were obtained. Arterial blood sampling for the time activity curve of the tracer was performed at the same time. According to the method of Phelps et al, MMRGlc was calculated in each of the region of interest (ROI) which was located in the left ventricular wall. MMRGlc obtained from each ROI was 0 to 17 mg/100 ml/min. In normal subjects MMRGlc was 0.4 to 7.3 mg/100 ml/min. In patients with myocardial infarction, it ranged from 3 to 5 mg/100 ml/min in the infarcted lesion. In patients with angina pectoris and subendocardial infarction, MMRGlc was 7 to 17 mg/100 ml/min in the ischemic lesion. In this lesion, myocardial blood flow was relatively low by oxygen-15 imagings (so-called mismatch). (J.P.N.)

  4. Detection of Ischemic Myocardium with a New Hypoxic Tissue Targeting Tracer 99Tcm-HL91

    Institute of Scientific and Technical Information of China (English)

    L(U) Jiagao; LIU Gang; FANG Ya; WU Hua

    2006-01-01

    The imaging appearances of 99Tcm-HL91, a new hypoxic imaging agent, in ischemic myocardium were studied and the value of 99 Tcm-HL91 in the evaluation of regional ischemic viable myocardium was explored. Acute myocardial ischemia models were made by coronary artery legations in 18 rats and randomly divided into 2 groups: 99Tcm-HL91 group and 99Tcm-MIBI group. Evan blue infusion during ischemia and TTC staining after operation were used to delineate the area of ischemic and viable myocardium. The isolated heart was sliced in the short axis and then autoradiography was performed. The electron microscopic examination was also done for the myocardial samples. 99Tcm-HL91 and 99Tcm-MIBI uptake activities (counts/g) were measured in the area of ischemic myocardium (T) and normal myocardium (NT) separately. The uptake ratios of 99Tcm-HL91 and that of 99Tcm-MIBI in ischemic myocardium were calculated as T/NT. It was found that the normal myocardium was blue and ischemic or infarct myocardium was negative with Evans blue in all experiment rats. Both the normal and ischemic myocardium was in red color with TTC staining.In the 99Tcm-HL91 group the ischemic myocardium showed much higher uptake over normal myocardium, that was demonstrated both in the autoradiography and quantitative analysis. The ischemic/normal activity ratios were 1.634±0.354. It was suggested that 99Tcm-HL91 might accumulate in ischemic and viable myocardium, which is helpful in the evaluation of hypoxic but viable myocardium and potentially used as a imaging agent to assess myocardial viability.

  5. Innate immune inflammatory response in the acutely ischemic myocardium.

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    Deftereos, Spyridon; Angelidis, Christos; Bouras, Georgios; Raisakis, Konstantinos; Gerckens, Ulrich; Cleman, Michael W; Giannopoulos, Georgios

    2014-01-01

    The "holy grail" of modern interventional cardiology is the salvage of viable myocardial tissue in the distribution of an acutely occluded coronary artery. Thrombolysis and percutaneous coronary interventions, provided they can be delivered on time, can interrupt the occlusion and save tissue. At the same time restoring the patency of the coronary vessels and providing the ischemic myocardium with blood can cause additional tissue damage. A key element of ischemic and reperfusion injury and major determinant of the evolution of damage in the injured myocardium is the inflammatory response. The innate immune system initiates and directs this response which is a prerequisite for subsequent healing. The complement cascade is set in motion following the release of subcellular membrane constituents. Endogenous 'danger' signals known as danger-associated molecular patterns (DAMPs) released from ischemic and dying cells alert the innate immune system and activate several signal transduction pathways through interactions with the highly conserved Toll like receptors (TLRs). Reactive oxygen species (ROS) generation directly induces pro-inflammatory cascades and triggers formation of the inflammasome. The challenge lies into designing strategies that specifically block the inflammatory cascades responsible for tissue damage without affecting those concerned with tissue healing.

  6. Strain rate imaging in assessing the size of acute ischemic myocardium in dogs

    Institute of Scientific and Technical Information of China (English)

    MU Yu-ming; GUAN Li-na; WANG Chun-mei; TANG Qi; CHEN Xiao-feng; HAN Wei

    2009-01-01

    Background Since the size of ischemic myocardium is closely related with both global and regional function of the myocardium, it is of great significance to measure the size of ischemic myocardium with non-invasive methods. Methods Eleven mongrel dogs were subjected to occlusion of the left anterior descending coronary artery for acute ischemia. Strain rate imaging had M-mode of strain-rate (CAMM) curve pointed from the basal segment of the anterior wall to the basal segment of the inferior wall to detect the border of ischemia size. The strain rate (SR) defined the cut-off value of ischemic myocardium in a two-chamber apical view, and marked by the anterior and inferior wall on two-dimensional images respectively. Along the endocardium and epicardium, the ischemic size was curved on two-dimensional images by the trackball method and then compared with the pathologically ischemic size. And then longitudinal strain rates were compared in the cut-off value, adjacent non-ischemic and ischemic segments at which the cut-off point was defined by changing the curve M-mode of strain rate after ischemia. Results Linear correlation existed between pathology and strain rate ischemic size (r=0.884, P <0.001). The SR parameters were lower in ischemia and cut-off point than in non-ischemic segments. The peak SRs of systole (SSR), early diastole (ESR), late diastole (ASR), strain during ejection time (εSR), and the maximum length change during the entire heart cycle (εmax) in ischemic segments lowered (P<0.05). Time to onset of regional relaxation (TR) was prolonged (P=0.012). Conclusion SR imaging can accurately assess the size of is, chemic myocardium.

  7. Unique Transcriptional Profile of Sustained Ligand-Activated Preconditioning in Pre- and Post-Ischemic Myocardium

    OpenAIRE

    Ashton, Kevin J; Amanda Tupicoff; Grant Williams-Pritchard; Kiessling, Can J.; See Hoe, Louise E; John P. Headrick; Peart, Jason N.

    2013-01-01

    BACKGROUND: Opioidergic SLP (sustained ligand-activated preconditioning) induced by 3-5 days of opioid receptor (OR) agonism induces persistent protection against ischemia-reperfusion (I-R) injury in young and aged hearts, and is mechanistically distinct from conventional preconditioning responses. We thus applied unbiased gene-array interrogation to identify molecular effects of SLP in pre- and post-ischemic myocardium. METHODOLOGY/PRINCIPAL FINDINGS: Male C57Bl/6 mice were implanted with 75...

  8. INFLUENCE OF COMPLETENESS HEART REVASCULARIZATION ON A FUNCTIONAL CONDITION OF MYOCARDIUM AT ISCHEMIC CARDIOMYOPATHY

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    V. V. Chestukhin

    2013-01-01

    Full Text Available The aim of this study was to define influence of completeness heart revascularization on a functional condition of myocardium at ischemic cardiomyopathy. Materials and methods. 61 men and 5 women aged from 46 till 73 years with the diagnosis an ischemic cardiomyopathy were investigated before and after coronary angioplasty (EDV LV – 256,1 ± 7,4 ml, EF LV – 36,1 ± 1,1%. 46 patients had at receipt CHF with NYHA functional class 4, 20 – CHF with NYHA functional class 3. Functional status (6-minute walking test – 109,7 ± 20,5 m. Chronic total occlusion was the major type of coronary artery disease (92 of 176 epicardial branches. By means of echocardiography and quantitative gated SPECT estimated dynamics of systolic and diastolic function, change of perfusion, thickening and myocardial movement. Results. The full revascularization managed to be executed to 32 patients, incomplete – to 34 patients (34 occluded arteries didn't manage to be opened. In the whole group the 6-minute walking test incre- ased to 268,2 ± 19,9 m (p < 0,001, EF LV grew to 39,9±1,1% (p < 0,01 due to reduction of end systolic volume, degree of mitral regurgitation decreased from 1,6 ± 0,1 to 1,2 ± 0,1 (p < 0,007, pulmonary artery pressure decreased from 39,1 ± 1,7 to 32,1 ± 1,2 mm Hg (p < 0,01. Distinctions in dynamics of the main functional indicators between groups of complete and incomplete revascularization it isn't revealed. The factor of expressiveness of collateral blood flow in the region of occluded arteries probably compensates violation of an antegrade blood flow and defines a myocardial condition. Conclusion. The volume of myocardial revascularization at patients with ischemic cardio- myopathy isn't defining factor in a clinical condition of them after executed percutaneous coronary intervention. 

  9. The iron-regulatory peptide hepcidin is upregulated in the ischemic and in the remote myocardium after myocardial infarction.

    Science.gov (United States)

    Simonis, Gregor; Mueller, Katrin; Schwarz, Peggy; Wiedemann, Stephan; Adler, Guido; Strasser, Ruth H; Kulaksiz, Hasan

    2010-09-01

    Recent evidence suggests that iron metabolism contributes to the ischemic damage after myocardial infarction. Hepcidin, a recently discovered peptide hormone, regulates iron uptake and metabolism, protecting the body from iron overload. In this study we analyzed the regulation of hepcidin in the heart and blood of rats after myocardial infarction. To induce a myocardial infarction in the rats, left anterior descending coronary artery ligation was performed. After 1-24h, biopsies from the ischemic and the non-ischemic myocardium were taken. In these biopsies, the mRNA levels and the protein expression of hepcidin were analyzed by quantitative RT-PCR and immunoblot analysis, respectively. In parallel, the serum levels of prohepcidin were measured by ELISA. Six hours after myocardial infarction, the hepcidin mRNA expression was temporally upregulated in the ischemic and in the non-ischemic myocardium. The upregulation was specific for hepcidin, since other iron-related genes (hemojuvelin, IREG-1) remained unchanged. Furthermore, the alteration of the hepcidin protein expression in the ischemic area was connected to the level of hepcidin in the serum of the infarcted rats, where hepcidin also raised up. Angiotensin receptor blockade with candesartan did not influence the mRNA regulation of hepcidin. Together, these data show a particular upregulation of the iron-regulatory peptide hepcidin in the ischemic and the non-ischemic myocardium after myocardial infarction. It is speculated that upregulation of hepcidin may reduce iron toxicity and thus infarct size expansion in an infarcted heart.

  10. Passive targeting of ischemic-reperfused myocardium with adenosine-loaded silica nanoparticles

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    Galagudza M

    2012-04-01

    Full Text Available Michael Galagudza1, Dmitry Korolev1, Viktor Postnov2, Elena Naumisheva2, Yulia Grigorova3, Ivan Uskov1, Eugene Shlyakhto11Institute of Experimental Medicine, VA Almazov Federal Heart, Blood and Endocrinology Center, 2Chemical Faculty, St Petersburg State University, 3Department of Pathophysiology, IP Pavlov State Medical University, St Petersburg, Russian FederationAbstract: Pharmacological agents suggested for infarct size limitation have serious side effects when used at cardioprotective doses which hinders their translation into clinical practice. The solution to the problem might be direct delivery of cardioprotective drugs into ischemic-reperfused myocardium. In this study, we explored the potential of silica nanoparticles for passive delivery of adenosine, a prototype cardioprotective agent, into ischemic-reperfused heart tissue. In addition, the biodegradation of silica nanoparticles was studied both in vitro and in vivo. Immobilization of adenosine on the surface of silica nanoparticles resulted in enhancement of adenosine-mediated infarct size limitation in the rat model. Furthermore, the hypotensive effect of adenosine was attenuated after its adsorption on silica nanoparticles. We conclude that silica nanoparticles are biocompatible materials that might potentially be used as carriers for heart-targeted drug delivery.Keywords: silica nanoparticles, targeted drug delivery, myocardium, ischemia, reperfusion

  11. Accuracy of Dobutamine Stress Echocardiography in Detecting Recovery of Contractile Reserve after Revascularization of Ischemic Myocardium

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    Abas Ali karimi

    2007-09-01

    Full Text Available Background: This study was designed to investigate the accuracy of dobutamine stress echocardiography (DSE in detecting the post-revascularization recovery rate of contractile reserve (CR in ischemic myocardium. Methods: A total of 112 segments from seven patients with low ejection fraction (<35% and coronary artery disease were evaluated with DSE one week before and 12 weeks after coronary artery bypass graft surgery (CABG. Sensitivity, specificity, and positive and negative predictive values of DSE for detecting the recovery rate of CR were calculated based upon their standard definition and were presented with 95% confidence intervals (CI. Results: The mean baseline left ventricular ejection fraction was 31±4%, which reached 35±7% after CABG unremarkably. The recovery rates of resting function and CR were 18.2% and 50% for hypokinetic and 15.6% and 24.1 for akinetic segments respectively. Specificity, sensitivity, and positive and negative predictive values of DSE for detecting the recovery of CR were 83% (CI=69-97, 89% (CI=83-96, 94% (CI = 88-99, and 73 % (CI = 55-88, respectively. Conclusion: Despite acceptable sensitivity, specificity, and positive predictive value, DSE has a relatively lower negative predictive value for detecting the recovery of CR in ischemic myocardium and, consequently, the full extent of myocardial viability. Further sensitive techniques may, therefore, be needed to provide complementary information regarding long-term functional outcome.

  12. Allogeneic cardiospheres delivered via percutaneous transendocardial injection increase viable myocardium, decrease scar size, and attenuate cardiac dilatation in porcine ischemic cardiomyopathy.

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    Kristine Yee

    Full Text Available Epicardial injection of heart-derived cell products is safe and effective post-myocardial infarction (MI, but clinically-translatable transendocardial injection has never been evaluated. We sought to assess the feasibility, safety and efficacy of percutaneous transendocardial injection of heart-derived cells in porcine chronic ischemic cardiomyopathy.We studied a total of 89 minipigs; 63 completed the specified protocols. After NOGA-guided transendocardial injection, we quantified engraftment of escalating doses of allogeneic cardiospheres or cardiosphere-derived cells in minipigs (n = 22 post-MI. Next, a dose-ranging, blinded, randomized, placebo-controlled ("dose optimization" study of transendocardial injection of the better-engrafting product was performed in infarcted minipigs (n = 16. Finally, the superior product and dose (150 million cardiospheres were tested in a blinded, randomized, placebo-controlled ("pivotal" study (n = 22. Contrast-enhanced cardiac MRI revealed that all cardiosphere doses preserved systolic function and attenuated remodeling. The maximum feasible dose (150 million cells was most effective in reducing scar size, increasing viable myocardium and improving ejection fraction. In the pivotal study, eight weeks post-injection, histopathology demonstrated no excess inflammation, and no myocyte hypertrophy, in treated minipigs versus controls. No alloreactive donor-specific antibodies developed over time. MRI showed reduced scar size, increased viable mass, and attenuation of cardiac dilatation with no effect on ejection fraction in the treated group compared to placebo.Dose-optimized injection of allogeneic cardiospheres is safe, decreases scar size, increases viable myocardium, and attenuates cardiac dilatation in porcine chronic ischemic cardiomyopathy. The decreases in scar size, mirrored by increases in viable myocardium, are consistent with therapeutic regeneration.

  13. THE EFFECT OF ACUTE MYOCARDIUM ISCHEMIC ON HEART FUNCTION OF PREGNANCY RAT

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    Zheng Xiaopu; Ma Aiqun; Niu Changmin; Dong Anping; Han Ke; Liu Yu; Zhang Wei; Geng Tao

    2006-01-01

    Objective To investigate the effect of acute myocardium ischemic on heart function of pregnancy rat.Methods 13 female SD rats and 6 early pregnancy rats were divided into normal group, unpregnant group with acute myocardial infarction and early pregnant group with acute myocardial infarction. The anterior branch of the left coronary artery was ligated. 3 weeks later, Image 1.31 software was used to measure areas of myocardial infarction,and to evaluate hemodynamics of heart with powerLAB4.12, and cardiac tissues were stained with Massion. Results Compared with unpregnant group with acute myocardial infarction , the early pregnant group with acute myocardial infarction had less myocardial infarction area (28. 86% vs. 36. 8%), and had a higher left ventricle end systolic pressure, ±dp/dt max, and lower left ventricle end diastolic pressure. Massion stain showed the amount of collagen of the lesion was less in the early pregnant group with acute myocardial infarction than that in unpregnant group.Conclusion The early pregnant group with acute myocardial infarction had better heart contractive and diastolic function.

  14. State of myocardium perfusion from scintigraphic data with thallium-201 and myoglobin level in patients with myocardium infarction and chronic ischemia

    International Nuclear Information System (INIS)

    The results permitting to consider that increase of myoglobin level contentin blood serum in patients with myocardium infarction and chronic ischemia, when carrying out the final functional load examination is the reason of myocardium perfusion disorder, occuring in response to threshold physical load, are obtained

  15. Impaired mitochondrial function in chronically ischemic human heart

    DEFF Research Database (Denmark)

    Stride, Nis Ottesen; Larsen, Steen; Hey-Mogensen, Martin;

    2013-01-01

    , and finally to assess myocardial antioxidant levels. Mitochondrial respiration in biopsies from ischemic and nonischemic regions from the left ventricle of the same heart was compared in nine human subjects. Maximal oxidative phosphorylation capacity in fresh muscle fibers was lower in ischemic compared.......05), and the levels of antioxidant protein expression was lower. Diminished mitochondrial respiration capacity and excessive ROS production demonstrate an impaired mitochondrial function in ischemic human heart muscle. No chronic ischemic preconditioning effect was found....

  16. Unique transcriptional profile of sustained ligand-activated preconditioning in pre- and post-ischemic myocardium.

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    Kevin J Ashton

    Full Text Available BACKGROUND: Opioidergic SLP (sustained ligand-activated preconditioning induced by 3-5 days of opioid receptor (OR agonism induces persistent protection against ischemia-reperfusion (I-R injury in young and aged hearts, and is mechanistically distinct from conventional preconditioning responses. We thus applied unbiased gene-array interrogation to identify molecular effects of SLP in pre- and post-ischemic myocardium. METHODOLOGY/PRINCIPAL FINDINGS: Male C57Bl/6 mice were implanted with 75 mg morphine or placebo pellets for 5 days. Resultant SLP did not modify cardiac function, and markedly reduced dysfunction and injury in perfused hearts subjected to 25 min ischemia/45 min reperfusion. Microarray analysis identified 14 up- and 86 down-regulated genes in normoxic hearts from SLP mice (≥1.3-fold change, FDR≤5%. Induced genes encoded sarcomeric/contractile proteins (Myh7, Mybpc3,Myom2,Des, natriuretic peptides (Nppa,Nppb and stress-signaling elements (Csda,Ptgds. Highly repressed genes primarily encoded chemokines (Ccl2,Ccl4,Ccl7,Ccl9,Ccl13,Ccl3l3,Cxcl3, cytokines (Il1b,Il6,Tnf and other proteins involved in inflammation/immunity (C3,Cd74,Cd83, Cd86,Hla-dbq1,Hla-drb1,Saa1,Selp,Serpina3, together with endoplasmic stress proteins (known: Dnajb1,Herpud1,Socs3; putative: Il6, Gadd45g,Rcan1 and transcriptional controllers (Egr2,Egr3, Fos,Hmox1,Nfkbid. Biological themes modified thus related to inflammation/immunity, together with cellular/cardiovascular movement and development. SLP also modified the transcriptional response to I-R (46 genes uniquely altered post-ischemia, which may influence later infarction/remodeling. This included up-regulated determinants of cellular resistance to oxidant (Mgst3,Gstm1,Gstm2 and other forms of stress (Xirp1,Ankrd1,Clu, and repression of stress-response genes (Hspa1a,Hspd1,Hsp90aa,Hsph1,Serpinh1 and Txnip. CONCLUSIONS: Protection via SLP is associated with transcriptional repression of inflammation/immunity, up

  17. Pathological mechanism for delayed hyperenhancement of chronic scarred myocardium in contrast agent enhanced magnetic resonance imaging.

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    Jian Wang

    Full Text Available OBJECTIVES: To evaluate possible mechanism for delayed hyperenhancement of scarred myocardium by investigating the relationship of contrast agent (CA first pass and delayed enhancement patterns with histopathological changes. MATERIALS AND METHODS: Eighteen pigs underwent 4 weeks ligation of 1 or 2 diagonal coronary arteries to induce chronic infarction. The hearts were then removed and perfused in a Langendorff apparatus. The hearts firstly experienced phosphorus 31 MR spectroscopy. The hearts in group I (n = 9 and II (n = 9 then received the bolus injection of Gadolinium diethylenetriamine pentaacetic acid (0.05 mmol/kg and gadolinium-based macromolecular agent (P792, 15 µmol/kg, respectively. First pass T2* MRI was acquired using a gradient echo sequence. Delayed enhanced T1 MRI was acquired with an inversion recovery sequence. Masson's trichrome and anti- von Willebrand Factor (vWF staining were performed for infarct characterization. RESULTS: Wash-in of both kinds of CA caused the sharp and dramatic T2* signal decrease of scarred myocardium similar to that of normal myocardium. Myocardial blood flow and microvessel density were significantly recovered in 4-week-old scar tissue. Steady state distribution volume (ΔR1 relaxation rate of Gd-DTPA was markedly higher in scarred myocardium than in normal myocardium, whereas ΔR1 relaxation rate of P792 did not differ significantly between scarred and normal myocardium. The ratio of extracellular volume to the total water volume was significantly greater in scarred myocardium than in normal myocardium. Scarred myocardium contained massive residual capillaries and dilated vessels. Histological stains indicated the extensively discrete matrix deposition and lack of cellular structure in scarred myocardium. CONCLUSIONS: Collateral circulation formation and residual vessel effectively delivered CA into scarred myocardium. However, residual vessel without abnormal hyperpermeability allowed Gd

  18. Experimental Model of Gene Transfection in Healthy Canine Myocardium: Perspectives of Gene Therapy for Ischemic Heart Disease

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    Renato A. K. Kalil

    2002-09-01

    Full Text Available OBJECTIVE: To assess the transfection of the gene that encodes green fluorescent protein (GFP through direct intramyocardial injection. METHODS: The pREGFP plasmid vector was used. The EGFP gene was inserted downstream from the constitutive promoter of the Rous sarcoma virus. Five male dogs were used (mean weight 13.5 kg, in which 0.5 mL of saline solution (n=1 or 0.5 mL of plasmid solution containing 0.5 µg of pREGFP/dog (n=4 were injected into the myocardium of the left ventricular lateral wall. The dogs were euthanized 1 week later, and cardiac biopsies were obtained. RESULTS: Fluorescence microscopy showed differences between the cells transfected and not transfected with pREGFP plasmid. Mild fluorescence was observed in the cardiac fibers that received saline solution; however, the myocardial cells transfected with pREGFP had overt EGFP expression. CONCLUSION: Transfection with the EGFP gene in healthy canine myocardium was effective. The reproduction of this efficacy using vascular endothelial growth factor (VEGF instead of EGFP aims at developing gene therapy for ischemic heart disease.

  19. Rhythminotropic Reactions of Human Myocardium in Ischemic and Rheumatic Heart Diseases against the Background of Amiodarone

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    Boris N. Kozlov, PhD, ScD

    2012-03-01

    Full Text Available In human heart failure, Ca2+ homeostasis gets disturbed due to a decrease in the function of the sarcoplasmic reticulum (SR. We studied the differences in the SR function in patients with rheumatic and coronary heart disease, against the background of amiodarone. Cardiac preparations from the atrium of 21 patients with coronary artery disease (CAD and 14 patients with rheumatic heart disease (RHD were used in this study. Myocardial strips perfused with oxygenated Krebs-Henzelait solution without and with amiodarone (1 mM/l at 37°C. The steady state stimulation rate of the muscle strips was 0.5 Hz. The single extraordinary impulse was given as 0.2-1.5 sec after the steady state beat. Then, the first beat after a 4- to 60-sec rest period was evaluated. The extrasystoles of the myocardium in both groups, after long intervals, were decreased after amiodarone treatment. The amplitude of post extrasystoles of amiodarone-treated myocardium showed differences only after long intervals in both groups. Two types of inotropic responses of a failing myocardium after rest periods were observed. Type I post-rest contractions maintained the steady state amplitude after all rests. However, type II was characterized by a reduction in the amplitude of the contractions. Amiodarone treatment of the myocardium showing type I reactions led to an increase in the potentiation after rests, but showed no effect on the reaction of the muscle with the type II response. The results suggested that SR dysfunction was different in CAD and RHD. The realization of the therapeutic effect of amiodarone was found to be dependent on the functional activity of the SR.

  20. Angiogenesis with intramyocardial administration of basic fibroblast growth factor in canine ischemic myocardium

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of intramyocardial administration of basic fibroblast growth factor on angiogenesis of infarcted myocardium in dogs. Methods: Twenty-four mongrel dogs were randomized into control group and therapeutic group. Acute myocardial infarction was made by ligation of the left anterior descending coronary artery distal to its first diagonal branch. As soon as coronary artery was occluded, 50 mg of basic fibroblast growth factor in 15 ml of saline was injected into the infarcted and border zone in therapeutic group, whereas 15 ml saline alone was used in the same way in control dogs. Every 3 dogs in each group was studied on the 1st day, the 3rd day, the 10th day, and the 17th day, respectively. Electron microscope was used to observe the growth of capillaries. Angiogenesis was evaluated by immunohistochemical studies with VIII factor. With sensitivity encoded technique, cine MR and MR perfusion imaging were performed on each dog within 3 hours after surgery and before euthanasia to evaluate cardiac function and the characteristics of myocardial perfusion. Results: In therapeutic group, LVEF improved markedly since the 10th day (on the 10th day: control group 24.09 ± 3.32, therapeutic group 45.71 ± 6.27; on the 17th day: control group 31.46 ± 4.60, therapeutic group 53.46 ± 5.24). Hypoenhancement on first pass and hyperenhancement on delayed phase appeared in infarcted myocardium. There were significant differences for the time of upslope, peak time of signal intensity, upslope curves ratio, and contrast enhancement ratio between infarcted and normal myocardium. The size of infarcted myocardium was markedly decreased on the 17th day [control group (9.04 ± 1.59)%, therapeutic group (4.07 ± 1.20)%]. The capillaries grew actively in therapeutic group and microvessel density was higher in therapeutic group than in control group except the first day (control group and therapeutic group respectively on the 3rd day: 92.3 ± 11.6, 147.3 ± 11

  1. Contradictory effects of short- and long-term hyperglycemias on ischemic injury of myocardium via intracellular signaling pathway.

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    Xu, Guang; Takashi, En; Kudo, Mitsuhiro; Ishiwata, Toshiyuki; Naito, Zenya

    2004-02-01

    Although clinical diabetes mellitus is obviously a high risk factor for myocardial infarction, there is disagreement about the sensitivity of ischemic injury of an infarcted myocardium in experimental studies. The present study evaluated the influences of different durations of hyperglycemia on ischemic and reperfusion injuries of the myocardium, and focused on extracellular signal-regulated kinase 1/2 (ERK1/2), which plays an important role in the intracellular signaling pathway and is reported to be associated with myocardial protection against heart injury. Short- and long-term hyperglycemias were induced in rats by streptozotocin (STZ) injection and the rats were examined 4 (4WDM) and 20 weeks (20WDM) after the treatment. Ischemia and reperfusion were induced by occlusion and reperfusion (I/R) of the left coronary artery (LCA). I/R-induced infarct size was determined using triphenyltetrazolium chloride (TTC) staining. After 20 weeks of STZ treatment (20WDM+I/R), the infarct size in the rat heart increased by 65.2 +/- 4.3%, whereas after 4 weeks of STZ treatment (4WDM+I/R), the infarct size decreased compared with the time-matched I/R group (43.1 +/- 3.6% and 59.5 +/- 5.6%, respectively). The number of dead myocytes including necrotic and apoptotic cells was determined using horseradish peroxidase (HRP) and terminal deoxynucleotide nick-end labeling (TUNEL) methods. The number of dead myocytes decreased in the 4WDM+I/R group, while the number of dead myocytes increased markedly in the 20WDM+I/R group, compared with the time-matched I/R group. The increment of ERK1/2 phosphorylation in the 4WDM group and the slight enhancement of this phosphorylation by I/R treatment were observed by western blotting. However, in the 20WDM group, the level of ERK1/2 phosphorylation reduced by approximately 1/3 compared with the time-matched control group; moreover, I/R treatment did not enhance the phosphorylation level. This study demonstrated that short- and long

  2. [The use of metabolic therapy in the treatment of ischemic heart disease in hemodynamically formed insignificant aortic stenosis with chronic heart failure].

    Science.gov (United States)

    Kuriata, A V; Karavanskaia, I L; Kushnir, Iu S

    2011-01-01

    Analysis of medical treatment was conducted with justified using of the metabolic component in a complex therapy of ischemic heart disease with chronic heart failure in hemodynamically formed insignificant aortic stenoses. The effect of metabolic correction is shown for pharmaceutical compounds Meldoniya in the form of Vasonat manufactured by "OlainFarm" (Latvia). Positive results of maintenance of systolic activity and prevention of diastolic dysfunction of myocardium were presented. The application of Vasonat in appropriate for the stabilization of adaptive properties of the myocardium and prophylaxis of the development of critical indicators of heart failure in this combined. PMID:22768738

  3. Metabolic consequences of beta-adrenergic receptor blockade for the acutely ischemic dog myocardium

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    Westera, G.; Hollander, W. den; Wall, E.E. van der; Eenige, M.J. van; Scholtalbers, S.; Visser, F.C.; Roos, J.P.

    1984-02-01

    In an experimental study in 50 dogs the myocardial uptake of free fatty acids (FFAs) after beta-blockade was determined using radioiodinated heptadecanoic acid as a metabolic tracer. All 4 beta-blockers used (metoprolol, timolol, propranolol and pindolol) lowered the uptake of FFAs in the normal canine heart. Uptake of FFAs was also diminished after coronary artery occlusion per se, but administration of beta-blockers exerted little additional influence on the uptake of FFAs. This observation was qualitatively parallelled by the uptake of /sup 201/Tl in concomitant experiments. Plasma FFA levels were increased by pindolol (non-selective with intrinsic sympathomimetic activity), not changed by metoprolol (a cardioselective betablocking agent) and lowered by timolol and propranolol (both non-selective compounds). The extent of ischemic tissue, as reflected by uptake of iodoheptadecanoic acid and /sup 201/Tl, was diminished by metoprolol but not by other beta-blockers. Regional distribution of both tracers, as shown in the endo-epicardial uptake ratios, was hardly influenced by beta-blockade, except for a small increase of /sup 201/Tl uptake in non-occluded endocardium. Uptake of /sup 201/Tl as well as of iodoheptadecanoic acid in the ischemic area was increased by metoprolol, timolol and propranolol and decreased by pindolol. We conclude that beta-blocking agents confer different effects on myocardial uptake and metabolism of FFAs which might possibly be related to their different inherent properties.

  4. Characteristics of regional sympathetic dysfunction in acutely ischemic myocardium assessed by {sup 123}I-metaiodobenzylguanidine imaging. Impairment of myocardial norepinephrine uptake or retention

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Yoshio; Hirose, Yoshiaki [National Cardiovascular Center, Suita, Osaka (Japan); Maeno, Masakazu [and others

    1995-07-01

    To characterize regional cardiac sympathetic dysfunction due to myocardial ischemia, we examined {sup 123}I-metaiodobenzylguanidine (MIBG) myocardial distribution of initial 15-min and 4-hr delayed SPECT images in 14 patients with recent myocardial infarction (MI), 25 patients with vasospastic angina which was angiographically proven with elgonovine maleate (Gp VSAP) and 16 patients with chest pain syndrome and normal CAG findings (Gp CP). In those with MI, the study was serially done at 2 weeks after (Gp MI-1) and at 3 months after the onset of MI (Gp MI-2). We estimated regional tracer uptake in 20 segments of tomographic images by using a 4-point scoring system (0=normal, 1=mild, 2=moderate, 3=severe reduction) and calculated the total defect score (IDS). In all patients with MI, the area of reduced MIBG uptake was more extensive than the {sup 201}Tl perfusion defect in the acute stage (Gp MI-1) indicating the presence of viable but denervated myocardial tissue. Also, the MIBG defect was persistently observed from initial (TDS: 24{+-}13) to delayed imaging (TDS: 26{+-}12). However, in the chronic stage (Gp MI-2), the initial MIBG uptake improved (TDS: 18 {+-}9) but the delayed uptake remained almost the same (TDS: 22{+-}10) indicating high washout of MIBG from the ischemic myocardium. Fourteen in Gp VSAP and 14 in Gp CP showed the regional MIBG defect in the delayed image more extensively than in the initial image indicating high washout of MIBG in the involved myocardial regions. These results suggest that neuronal uptake of MIBG is impaired in the acute stage of MI although neuronal retention of MIBG is predominantly impaired in the chronic stage of MI or in Gps VSAP and CP. (author).

  5. Evaluation of left ventricular remodelling in patients with chronic ischemic heart disease using multislice computer tomography and magnetic resonance tomography

    International Nuclear Information System (INIS)

    The article presents the results of MSCT and MRI of the heart in 57 patients with chronic coronary heart disease. It determined the relationship between structural and functional changes in the left ventricle and the degree of left coronary artery stenosis. Also determined were the link between the ischemic left ventricular remodeling and depth of myocardial damage in patients with coronary heart disease and postinfarction cardiosclerosis. MSCT and MRI are highly reliable imaging technique used to evaluate the infarcted and viable myocardium and post infarct cardiac remodeling process

  6. Cardiac events theoretically cannot be produced by non-ischemic and/or iso-ischemic myocardium: challenging postulations and vitality of the concept of “ischemia-dependent conflictogenic arrhythmias”

    Directory of Open Access Journals (Sweden)

    Dr. Petras Stirbys

    2013-12-01

    Full Text Available Ischemia plays a key role in cardiac arrhythmogenesis, particularly in elderly patients. Healthy, non-ischemic and structurally normal myocardium is universally free from dysrhythmias. Thereby intact coronary blood flow prevents potential cardiac events. Hypothetically, ischemia-related electrophysiological differences are responsible for the supraventricular and/or ventricular rhythm irregularities. The goal of this review is to determine the role of systemic and coronary circulatory peculiarities and their association with heart rhythm abnormalities. The current analytical review extends and enriches previous knowledge about the influence of these peculiarities on the genesis of ischemia-dependent conflictogenic arrhythmias. Different intensity of coronary blood flow resulting from stenotic obstacles or vasospasm potentially leads to the non-uniform perfusion of myocites thus creating albeit subtle but vulnerable and powerful electrophysiologic substrate impending cardiac rhythm disturbances. Apparently, the behavior of both non-ischemic and iso-ischemic myocardium in respect to electric cardiac activity is very similar, at least theoretically. Some different clinical entities, e.g. arterial hypotension and/or anemia containing ischemic component, in most cases are free from arrhythmias. This postulation may be helpful in furthering arrhythmogenicity insights which have been generated previously (1. On the contrary, increased blood pressure often concurs with the supraventricular and/or ventricular arrhythmias; this pattern also favorably reflects our previous hypothetical assumptions associated with the mechanisms of arrhythmogenesis. Conclusively, both non-ischemic and iso-ischemic myocardium may be attributed to nonarrhythmogenic milieu. Nevertheless, the inventive analysis and more explorative data are required to support the suggested postulations.

  7. Cardiac progenitor-derived exosomes protect ischemic myocardium from acute ischemia/reperfusion injury

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    Chen, Lijuan [Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Wang, Yingjie [Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Internal Medicine of Traditional Chinese Medicine, Shuguang Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 201203 (China); Pan, Yaohua; Zhang, Lan [Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Shen, Chengxing [Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai (China); Qin, Gangjian [Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 (United States); Ashraf, Muhammad [Pathology and Lab Med, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Weintraub, Neal [Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Ma, Genshan, E-mail: magenshan@hotmail.com [Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Tang, Yaoliang, E-mail: tangyg@ucmail.uc.edu [Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States)

    2013-02-15

    Highlights: ► Cardiac progenitor-derived (CPC) Exosomes protect H9C2 from apoptosis in vitro. ► CPC-exosomes protect cardiomyoyctes from MI/R induced apoptosis in vivo. ► CPC-exosomes were taken up by H9C2 with high efficiency using PKH26 labeling. ► miR-451, one of GATA4-responsive miRNA cluster, is enriched in CPC-exosomes. -- Abstract: Background: Cardiac progenitors (CPC) mediate cardioprotection via paracrine effects. To date, most of studies focused on secreted paracrine proteins. Here we investigated the CPC-derived-exosomes on protecting myocardium from acute ischemia/reperfusion (MI/R) injury. Methods and results: CPC were isolated from mouse heart using two-step protocol. Exosomes were purified from conditional medium, and confirmed by electron micrograph and Western blot using CD63 as a marker. qRT-PCR shows that CPC-exosomes have high level expression of GATA4-responsive-miR-451. Exosomes were ex vivo labeled with PKH26, We observed exosomes can be uptaken by H9C2 cardiomyoblasts with high efficiency after 12 h incubation. CPC-exosomes protect H9C2 from oxidative stress by inhibiting caspase 3/7 activation invitro. In vivo delivery of CPC-exosomes in an acute mouse myocardial ischemia/reperfusion model inhibited cardiomyocyte apoptosis by about 53% in comparison with PBS control (p < 0.05). Conclusion: Our results suggest, for the first time, the CPC-exosomes can be used as a therapeutic vehicle for cardioprotection, and highlights a new perspective for using non-cell exosomes for cardiac disease.

  8. Cardiac progenitor-derived exosomes protect ischemic myocardium from acute ischemia/reperfusion injury

    International Nuclear Information System (INIS)

    Highlights: ► Cardiac progenitor-derived (CPC) Exosomes protect H9C2 from apoptosis in vitro. ► CPC-exosomes protect cardiomyoyctes from MI/R induced apoptosis in vivo. ► CPC-exosomes were taken up by H9C2 with high efficiency using PKH26 labeling. ► miR-451, one of GATA4-responsive miRNA cluster, is enriched in CPC-exosomes. -- Abstract: Background: Cardiac progenitors (CPC) mediate cardioprotection via paracrine effects. To date, most of studies focused on secreted paracrine proteins. Here we investigated the CPC-derived-exosomes on protecting myocardium from acute ischemia/reperfusion (MI/R) injury. Methods and results: CPC were isolated from mouse heart using two-step protocol. Exosomes were purified from conditional medium, and confirmed by electron micrograph and Western blot using CD63 as a marker. qRT-PCR shows that CPC-exosomes have high level expression of GATA4-responsive-miR-451. Exosomes were ex vivo labeled with PKH26, We observed exosomes can be uptaken by H9C2 cardiomyoblasts with high efficiency after 12 h incubation. CPC-exosomes protect H9C2 from oxidative stress by inhibiting caspase 3/7 activation invitro. In vivo delivery of CPC-exosomes in an acute mouse myocardial ischemia/reperfusion model inhibited cardiomyocyte apoptosis by about 53% in comparison with PBS control (p < 0.05). Conclusion: Our results suggest, for the first time, the CPC-exosomes can be used as a therapeutic vehicle for cardioprotection, and highlights a new perspective for using non-cell exosomes for cardiac disease

  9. Pathophysiology and diagnosis of hibernating myocardium in patients with post-ischemic heart failure. The contribution of PET

    International Nuclear Information System (INIS)

    Identification and treatment of hibernating myocardium (HM) lead to improvement in left ventricular (LV) function and prognosis in patients with post-ischemic heart failure. Different techniques are used to diagnose HM: echocardiography, MRI, SPECT and PET and, in patients with moderate LV impairment, their predictive values are similar. There are few data on patients with severe LV dysfunction and heart failure in whom the greatest benefits are apparent after revascularization. Quantification of FDG uptake with PET during hyperinsulinemic euglycemic clamp is accurate in these patients with the greatest mortality risk in whom other techniques may give high false negative rates. The debate on whether resting myocardial blood flow to HM is reduced or not has stimulated new research on heart failure in patients with coronary artery disease. PET with H215O or 13NH3 has been used for the absolute quantification of regional blood flow in human HM. When HM is properly identified, resting blood flow is not different from that in healthy volunteers although a reduction of ∼20% can be demonstrated in a minority of cases. PET studies have shown that the main feature of HM is a severe impairment of coronary vasodilator reserve that improves after revascularization in parallel with LV function. Thus, the pathophysiology of HM is more complex than initially postulated. The recent evidence that repetitive ischemia in patients can be cumulative and lead to more severe and prolonged stunning, lends further support to the hypothesis that, at least initially, stunning and HM are two facets of the same coin. (author)

  10. Usefulness of residual ischemic myocardium within prior infarct zone for identifying patients at high risk late after acute myocardial infarction.

    Science.gov (United States)

    Brown, K A; Weiss, R M; Clements, J P; Wackers, F J

    1987-07-01

    This study examines the prognostic implications of ischemia within the territory of a prior acute myocardial infarction (AMI) vs ischemia at a distance, which develops late after AMI. Sixty-one consecutive patients who underwent both exercise thallium-201 (TI-201) imaging and cardiac catheterization for evaluation of chest pain that developed after discharge from the hospital for AMI form the study group. Mean interval between infarction to the TI-201 study was 10 +/- 17 months. Initial and 2-hour delay TI-201 images were analyzed quantitatively to determine the presence and location (within vs outside the prior infarct zone) of TI-201 redistribution, a marker of ischemic viable myocardium. TI-201 imaging results were separated into 3 groups based on presence and location of TI-201 redistribution: no significant TI-201 redistribution was found in 16 patients; in 29, TI-201 redistribution was confined to the infarct zone; and in 16, TI-201 redistribution was outside the infarct zone. Stepwise multivariate logistic regression analysis was used to examine the comparative ability of TI-201 results and other patient variables to predict cardiac events. For total cardiac events (cardiac death, recurrent nonfatal AMI, unstable angina and coronary revascularization), both the presence of any TI-201 redistribution and multivessel angiographic coronary artery disease were significant predictors. However, when coronary revascularization was excluded as an endpoint, TI-201 redistribution limited to the prior infarct zone was the only significant predictor of cardiac events. All 8 cardiac events occurred in patients with T1-201 redistribution limited to the infart zone.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Complement component 3 is necessary to preserve myocardium and myocardial function in chronic myocardial infarction.

    Science.gov (United States)

    Wysoczynski, Marcin; Solanki, Mitesh; Borkowska, Sylwia; van Hoose, Patrick; Brittian, Kenneth R; Prabhu, Sumanth D; Ratajczak, Mariusz Z; Rokosh, Gregg

    2014-09-01

    Activation of the complement cascade (CC) with myocardial infarction (MI) acutely initiates immune cell infiltration, membrane attack complex formation on injured myocytes, and exacerbates myocardial injury. Recent studies implicate the CC in mobilization of stem/progenitor cells and tissue regeneration. Its role in chronic MI is unknown. Here, we consider complement component C3, in the chronic response to MI. C3 knockout (KO) mice were studied after permanent coronary artery ligation. C3 deficiency exacerbated myocardial dysfunction 28 days after MI compared to WT with further impaired systolic function and LV dilation despite similar infarct size 24 hours post-MI. Morphometric analysis 28 days post-MI showed C3 KO mice had more scar tissue with less viable myocardium within the infarct zone which correlated with decreased c-kit(pos) cardiac stem/progenitor cells (CPSC), decreased proliferating Ki67(pos) CSPCs and decreased formation of new BrdU(pos) /α-sarcomeric actin(pos) myocytes, and increased apoptosis compared to WT. Decreased CSPCs and increased apoptosis were evident 7 days post-MI in C3 KO hearts. The inflammatory response with MI was attenuated in the C3 KO and was accompanied by attenuated hematopoietic, pluripotent, and cardiac stem/progenitor cell mobilization into the peripheral blood 72 hours post-MI. These results are the first to demonstrate that CC, through C3, contributes to myocardial preservation and regeneration in response to chronic MI. Responses in the C3 KO infer that C3 activation in response to MI expands the resident CSPC population, increases new myocyte formation, increases and preserves myocardium, inflammatory response, and bone marrow stem/progenitor cell mobilization to preserve myocardial function.

  12. Ultrastructural and tissue restructuring of the rat atrial myocardium under the influence of acute and chronic prenatal hypoxia

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    Shevchenko K. M.

    2015-09-01

    Full Text Available Background. There are relatively few researches that focused on the study of the influence of hypoxia on atrial myocardium. However the results of previous researches are contradictory and fragmentary, that leades to the further study of this item. Objective. Purpose of the work was to determine the tissue, cellular and ultrastructural changes of the rat atrial myocardium during the stages of cardiogenesis under the conditions of acute and chronic prenatal hypoxia. Methods. Embryo hearts were investigated on 14th, 16th and 18th day of prenatal ontogenesis, newborn rat hearts and the hearts of rats on the 3rd, 14th and 30th day of postnatal ontogenesis. Animals were subdivided into three groups: first experimental group animals were exposed to acute prenatal hypoxia, second experimental group animals were exposed to chronic prenatal hypoxia and control group animals. Hypoxia modeling was conducted on pregnant females by injection of 1% sodium nitrite intraperitonealy in doses that lead to moderate hypoxia. During the work complex of histological, immunohistochemical and morphometric methods was used. Results and conclusion. Effect of acute hypoxia leads to stimulation of proliferative activity of fibroblasts and endothelial cells on the right atrium, which causes to increasing of the relative volume of connective tissue and blood vessels of microvasculature of myocardium. Relative volume of connective tissue of the atrial myocardium exceeds significantly the control level of newborn rats. Ultrastructural changes of the atrial cardiomyocytes in 3 days after the influence of acute prenatal hypoxia reveals on violation of mitochondrial structure, significant inhibition of myofibrils accumulation. Until the birth of most of morphometric parameters renewal and reach control levels, however changes of the degree of myofibrils orientation on the left atrium proves stability of hypoxic damages. Chronic prenatal hypoxia causes a significant increase of

  13. Fibrin patch-based insulin-like growth factor-1 gene-modified stem cell transplantation repairs ischemic myocardium

    Science.gov (United States)

    Li, Jun; Zhu, Kai; Yang, Shan; Wang, Yulin; Guo, Changfa; Yin, Kanhua; Wang, Chunsheng

    2015-01-01

    Bone marrow mesenchymal stem cells (BMSCs), tissue-engineered cardiac patch, and therapeutic gene have all been proposed as promising therapy strategies for cardiac repair after myocardial infarction. In our study, BMSCs were modified with insulin-like growth factor-1 (IGF-1) gene, loaded into a fibrin patch, and then transplanted into a porcine model of ischemia/reperfusion (I/R) myocardium injury. The results demonstrated that IGF-1 gene overexpression could promote proliferation of endothelial cells and cardiomyocyte-like differentiation of BMSCs in vitro. Four weeks after transplantation of fibrin patch loaded with gene-modified BMSCs, IGF-1 overexpression could successfully promote angiogenesis, inhibit remodeling, increase grafted cell survival and reduce apoptosis. In conclusion, the integrated strategy, which combined fibrin patch with IGF-1 gene modified BMSCs, could promote the histological cardiac repair for a clinically relevant porcine model of I/R myocardium injury. PMID:25767192

  14. Effects of Chinese herbs capable of replenishing qi,nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium

    Institute of Scientific and Technical Information of China (English)

    YIN HuiJun; GUO ChunYu; SHI DaZhuo

    2009-01-01

    This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi,nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium which were selected from differential expression profile we had established before,and to explore the underlying mechanism. The acute myocardial infarction (AMI) model was established by ligating the left anterior descending (LAD) coronary artery,then the model rats were randomly divided into the model group,the Metoprolol group,the replenishing qi nourishing yin (RN)group,the activating blood circulation (AB) group,and the replenishing qi,nourishing yin and activating blood circulation (RA) group. In addition,the normal group and the sham group were set up. The rats of medication groups were administered by intragastric gavage with corresponding drugs on the second day after operations,and the rats of the normal group and the sham group were given normal saline as the same time.Then the ischemic hearts were harvested on the 8th day after operation. The myocardial pathomorphological changes were observed under a light microscope. The mRNA changes of target genes such as COX5a and ATP5e were detected using Real-time fluorescence quantitative PCR (Q-PCR),and the activities of related enzymes were detected by colorimetric assay. The main results were as follows:the histological changes were observed by HE staining,and cardiocyte swelling,inflammatory cell infiltration and cytolysis were showed in regional ischemic myocardium of the model group,while the pathomorphological changes in all medication groups did not show obvious changes.Two genes related to energy metabolism,COX5a and ATP5e,were selected as the target genes which were down-regulated at the mRNA level in the medication groups. The activities of correlative functional enzymes also decreased in the RA group compared to that in the model group accordingly (P<0.05). The results indicated

  15. Study of the expression of apelin and its recoptor in ischemic myocardium in insulin-resistant rats

    Institute of Scientific and Technical Information of China (English)

    魏芳晶

    2013-01-01

    Objective To investigate the expression of apelin and its recoptor (APJ) in myocardium in insulin-resistant CIR rats with myocardial ischemia.Methods Totally 24male SD rats were randomly divided into three groups:IR group,IR+ischemia group,the control group (n=8each) .Rats in IR and IR+ischemia groups were fed with the high fat diet.Rats in control group were given the basic diet.The rat model of insulin resistance was assessed by fasting blood glucose (FBG) ,fasting insulin (Fins) and insulin resistance index (HOMA-IR) .The

  16. No evidence for activated autophagy in left ventricular myocardium at early reperfusion with protection by remote ischemic preconditioning in patients undergoing coronary artery bypass grafting.

    Directory of Open Access Journals (Sweden)

    Nilgün Gedik

    Full Text Available Remote ischemic preconditioning (RIPC by repeated brief limb ischemia/reperfusion reduces myocardial injury in patients undergoing coronary artery bypass grafting (CABG. Activation of signal transducer and activator of transcription 5 (STAT5 in left ventricular (LV myocardium at early reperfusion is associated with such protection. Autophagy, i.e., removal of dysfunctional cellular components through lysosomes, has been proposed as one mechanism of cardioprotection. Therefore, we analyzed whether or not the protection by RIPC is associated with activated autophagy.CABG patients were randomized to undergo RIPC (3×5 min blood pressure cuff inflation/5 min deflation or placebo (cuff deflated before skin incision (n = 10/10. Transmural myocardial biopsies were taken from the LV before cardioplegia (baseline and at early (5-10 min reperfusion. RIPC-induced protection was reflected by decreased serum troponin I concentration area under the curve (194±17 versus 709±129 ng/ml × 72 h, p = 0.002. Western blotting for beclin-1-phosphorylation and protein expression of autophagy-related gene 5-12 (ATG5-12 complex, light chain 3 (LC3, parkin, and p62 was performed. STAT3-, STAT5- and extracellular signal-regulated protein kinase 1/2 (ERK1/2-phosphorylation was used as positive control to confirm signal activation by ischemia/reperfusion.Signals of all analyzed autophagy proteins did not differ between baseline and early reperfusion and not between RIPC and placebo. STAT5-phosphorylation was greater at early reperfusion only with RIPC (2.2-fold, p = 0.02. STAT3- and ERK1/2-phosphorylation were greater at early reperfusion with placebo and RIPC (≥2.7-fold versus baseline, p≤0.05.Protection through RIPC in patients undergoing CABG surgery does not appear to be associated with enhanced autophagy in LV myocardium at early reperfusion.

  17. [CHARACTERISTIC OF ALTERATIONS OF ARTERIES IN PATIENTS WITH ISCHEMIC HEART DISEASE AND CHRONIC HEPATITIS C].

    Science.gov (United States)

    Guliaev, N I; Kuznetsov, V V; Poltareĭko, D S; Qleksiuk, I B; Gordienko, A V; Barsukov, A V

    2015-01-01

    The article presents an assessment of degree and type of atherosclerosis of coronary and non-coronary vessels in old patients with ischemic heart disease associated with chronic viral hepatitis C (VHC), the incidence of myocardial infarction and the possibility of participation chronic VHC in atherogenesis. Patients with ischemic heart disease have correlation of atherosclerosis of arteries with age, hypercholesterinemia. Patients without chronic VHC more often give a higher risk of myocardial infarction, especially in early period (1-1,5 years) of onset of ischemic heart disease clinical implications. Patients with ischemic heart disease associated with chronic viral hepatitis C more often have generalized alterations in vessels, multifocal type of alteration. So, participation of VHC in atherogenesis is most probably connected with maintenance of chronic immune inflammation in vascular endothelium.

  18. Assessment of Viable Myocardium with Nuclear Imaging

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    Kang, Won Jun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2009-06-15

    Nuclear cardiac imaging has been widely used to assess viable myocardium in patients with ischemic heart disease. The assessment of viable myocardium is important in selecting patients who will be benefit from revascularization. Although revascularization is indicated in patients with sufficient myocardium, patients with scar tissue should be treated medically. Nuclear imaging methods including myocardial perfusion SPECT and FDG PET have been shown to be effective modalities for identifying viable myocardium.

  19. Studies on Tl-201 single photon emission computed tomography (SPECT) of myocardium in patients with ischemic heart disease

    International Nuclear Information System (INIS)

    Seventy-six patients with IHD were divided into 2 groups, A) angina pectoris (n=50) and B) previous myocardial infarction(n=26). Each group was classified into three subgroups, without considering hypertension, that is 1) without complication, 2) with hypercholesterolemia, and 3) with diabetes mellitus. We studied and compared the findings of ECG, Echocardiogram (ECHO) and Emission CT (ECT) in these patients at rest. In the previous myocardial infarction group (Group B), we could find 100% ischemic patterns on ECG, 100% asynergy of either IVS or the posterior wall on ECHO and higher percentages of various grade of perfusion defects on ECT compared with group A. In group A, the percentages of perfusion defects were similar in three subgroups. But interestingly, in the hypercholesterolemic group, we could find diffuse moth-eaten like low perfusion areas on ECT. Further study is required whether this finding is peculiar for angina pectoris with hypercholesterolemia or an artifact on ECT. The percentage of ischemic patterns on ECG was lower than in the other groups. In angina pectoris with diabetes mellitus, asynergy in ECHO finding was a significantly higher percentage, compared with other groups. We believe, that ECG, ECHO and ECT are of compensatory importance in the diagnosis of patients with IHD. (author)

  20. Influence of Kinesitherapy on Gait in Patients with Ischemic Stroke in the Chronic Period

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    Danche Vasileva

    2015-10-01

    CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as exercise program at home, which significantly improved gait cadence and speed of movement in patients with ischemic stroke in the chronic period and is with a supportive prolonged exposure.

  1. DOBUTAMINE MAGNETIC RESONANCE IMAGING PREDICTS CONTRACTILE RESERVE OF CHRONICALLY DYSFUNCTIONAL MYOCARDIUM: COMPARISON WITH FLUORINE-18 FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. This study sought to investigate whether low-dose dobutamine-MRI can detect residual myocardial viability in patients with chronic myocardial infarction and left ventricular dysfunction.Methods. Eleven patients with chronic myocardial infarction and left ventricular dysfunction were employed for identification of viable myocardium by cine-MRI during dobutamine infusion. All patients underwent coronary angiography and left ventriculography,18FDG-PET, MRI at rest and stress.The systolic wall thickening measured at rest and during stress was compared with the results of 18FDG- PET, respectively.Results. A significant difference of either dobutamine-induced systolic wall thickening (SWthstress) or dobutamine-induced contractile reserve (ΔSWth= SWthstress- SWthrest) was present between viable and scar regions (1.0±0.3 versus -0.3 ±0.1, P<0.01; 1.0±0.3 versus -0.2±0.2, P<0.01).

  2. IMPLANTATION OF AUTOLOGOUS BONE MARROW MONONUCLEAR CELLS INTO ISCHEMIC MYOCARDIUM ENHANCES CORONARY CAPILLARIES AND SYSTOLIC FUNCTION IN MINISWINE

    Institute of Scientific and Technical Information of China (English)

    Chong-jian Li; Ji-lin Chen; Jian-jun Li; Run-lin Gao; Yue-jin Yang; Feng-huan Hu; Wei-xian Yang; Shi-jie You; Lai-feng Song; Ying-mao Ruan; Shu-bin Qiao

    2008-01-01

    Objective To investigate the therapeutic effectiveness of intracoronary implantation of autologous bone marrow mononuelear cells (BM-MNC) in miniswine model of reperfused myocardial infarction.Methods Sixteen miniswine myocardial isehemic reperfusion injury models made by ligation of the distal one third segment of left anterior descending artery for 90 minutes were randomized into 2 groups.In BM-MNC group (n=9),(3.54±0.90)×108 BM-MNC were intracoronary injected,and in the control group (n=7),phosphate buffered saline was injected by the same way.Echoeardiographic and hemodynamic results,vessel density,and myocardial infarction size were evaluated and compared before and 4 weeks after cell transplantation.Results In BM-MNC group,there were no differences between before and 4 weeks after transplantation in aspects of left ventricular ejection fraction (LVEF),interventricular septai thickness,left ventricular lateral and anterior septal wall thickness,cardiac output,or +dp/dtmax.In control group,LVEF,interventrieular septal thickness,left ventricular lateral and anterior septal wall thickness,cardiac output,and +dp/dtmax decreased significantly 4 weeks after transplantation (P<0.05).Left ventricular end-diastolic pressure and -dp/dtmax did not change significantly before and after cell transplantation in both groups.Capillary density in BM-MNC group was greater than that in control group [(13.39±6.96)/high power field vs.(3.50 ± 1.90)/high power field,P<0.05].Infarction area assessed by tetrazolium red staining and the infarction percentage decreased in BM-MNC group compared with those in control group (P<0.05).Conclusions Transplantation of BM-MNC into myocardium with isehemie reperfusion injury increases capillary density and decreases infarction area.It has significantly beneficial effect on cardiac systolic function rather than on diastolic function.

  3. MYOCARDIAL PERFUSION ASSESSMENT IN FORECASTING EFFECT OF CORONARY ANGIOPLASTY IN PATIENTS WITH ISCHEMIC CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. B. Mironkov

    2015-01-01

    Full Text Available Aim. To define influence of the left ventricle (LV perfusion defects on the clinical status dynamics after coronary angioplasty in patients with the expressed myocardium dysfunction of ischemic etiology. Materials and methods. Examined 86 patients (81 men and 5 women aged from 46 to 73 years before and in 2–3 days after percutaneous coronary intervention with diagnosis: CAD, CHF with NYHA class III–IV, echocardiography parameters of LV: ejection fraction less than 40%, end-diastolic volume is more than 200 ml. Perfusion defects of myocardium estimated with use of ECG-gated single photon emission computed tomography. Predictors were defined: perfusion defects on LV apex (in score, perfusion defects in the area of LAD, LCx and RCA (%, the LV global perfusion defects (in score and %. Results. In 42% of cases 6-minute walk test increased to 3 times; The NYHA class decreased by 2 classes (group 1. In 28 cases 6-minute walk test increased to 2 times and the NYHA class decreased on 1 class. In 22 patients 6-minute walk test increased less than 50% of reference values and there was no dynamics NYHA class (50 patients of the group 2. Initial extent of LV global perfusion defects in group 1 – 41,2 ± 4,0%, in group 2 – 58,3 ± 2,4% (р = 0,0004. Similar values are received for perfusion indicators in the area of LAD and the LV apex. Prevalence of myocardial perfusion defects at rest reflects prevalence of a cardiosclerosis in a cardiac muscle. Conclusion. Degree of LV myocardial perfusion defects in patients with the expressed heart failure of ischemic etiology is the key indicator influencing clinical efficiency of coronary angioplasty. Critical size for definition of the favorable forecast of revascularization are 60% and more perfusion defects testifying that in a cardiac muscle the focal cardiosclerosis prevails over the functioning myocardium

  4. Correlation of Functional Values of Left Ventricular Myocardium and the Data of Subjective State of Patients with Chronic Coronary Occlusion

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    Shakhov Е.B.

    2012-03-01

    Full Text Available The aim of the investigation is to study the correlation of functional values of left ventricular myocardium and the data of subjective state of patients with chronic coronary occlusion according to echocardiography findings and a new technique of subjective state assessment of patients with incomplete myocardial revascularization. Materials and Methods. The treatment results of 74 patients with coronary occlusion were analyzed. The 1st group consisted of 35 (47% patients with chronic occlusion localized in the right coronary artery, the 2nd ­— 15 (20% patients with chronic occlusion in anterior descending artery, the 3rd — 24 (33% patients with chronic occlusion of circumflex branch of coronary artery. All the patients underwent complete clinical and instrumental examination including echocardiography, angiography and history taking of subjective state of patients. Subjective state of patients was assessed by an original technique three times: preoperatively, a day after admission; on the 3rd day after the operation, and 3 months after surgery. The results obtained were correlated with the effect of the disease and X-ray endovascular treatment on physical, psychological, emotional and social states of a person. Conclusion. According to the technique of subjective state assessment of patients developed by the authors, incomplete X-ray endovascular myocardial revascularization contributes to the increase of psychological and social level functioning in early postoperative periods. In accordance with the echocardiography findings, complete recovery of left ventricular myocardial function in arterial occlusive disease can fail to be observed in early postoperative periods due to collateral myocardial hypoperfusion in the zone of chronic ischemia.

  5. Ischemic colitis during interferon-ribavirin therapy for chronic hepatitis C: A case report

    Institute of Scientific and Technical Information of China (English)

    Su Jung Baik; Tae Hun Kim; Kwon Yoo; Il Hwan Moon; Min-Sun Cho

    2012-01-01

    Ischemic colitis is a rare complication of interferon administration.Only 9 cases in 6 reports have been described to-date.This report describes a case of ischemic colitis during pegylated interferon and ribavirin treatment for chronic hepatitis C,and includes a review of the relevant literature.A 48-year-old woman was treated with pegylated interferon α-2a and ribavirin for chronic hepatitis C,genotype Ib.After 19 wk of treatment,the patient complained of severe afebrile abdominal pain with hematochezia.Vital signs were stable and serum white blood cell count was within the normal range.Abdominal computed tomography showed diffuse colonic wall thickening from the splenic flexure to the proximal sigmoid colon,which is the most vulnerable area for the development of ischemic colitis.Colonoscopy revealed an acute mucosal hyperemic change,with edema and ulcerations extending from the proximal descending colon to the sigmoid colon.Colonic mucosal biopsy revealed acute exudative colitis.Polymerase chain reaction and culture for Mycobacterium tuberculosis were negative and the cultures for cytomegalovirus,Salmonella and Shigel/a species were negative.After discontinuation of interferon and ribavirin therapy,abdominal pain and hematochezia subsided and,following colonoscopy showed improvement of the mucosal ulcerations.Ischemic colitis cases during interferon therapy in patients with chronic hepatitis C reported so far have all involved the descending colon.Ischemic colitis is a rarely encountered complication of interferon administration in patients with chronic hepatitis C and should be considered when a patient complains of abdominal pain and hematochezia.

  6. EVALUATION CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. J. Fishman

    2011-01-01

    Full Text Available Objective — studying dyssynchrony characteristics and evaluation correction effectiveness in patients with chronic heart failure (CHF of ischemic origin.Materials and methods. The study included 125 patients with chronic heart failure of ischemic etiology, 28 of them — with coronary heart disease (CHD who had undergone aorto-and / or mammarokoronary bypass and / or percutaneous coronary intervention, 42 — with coronary artery disease and postinfarction cardiosclerosis, 32 — with arrhythmic variant of coronary artery disease, 23 — with stable angina without evidence of arrhythmia. Among included patients, biventricular pacemakers were implanted for 17 patients. All patients underwent echocardiography with determination of the parameters of dyssynchrony.Results and conclusion. Among patients with CHF ischemic symptoms dyssynchrony was diagnosed in 36 (28.8 % cases. Statistically significant association between patients with cardiac arrhythmias and dyssynchrony was determined. At the same time the incidence of dyssynchrony was not associated with various forms of ischemic heart disease, and did not depend on the anamnesis of cardiac surgery. Dependence of the frequency of occurrence of dyssynchrony on the severity of CHF was revealed. Patients selected for implantation of biventricular pacemakers, especially in view of echocardiographic signs of dyssynchrony had significant improvement after providing cardiac resynchronization therapy. Effect of the treatment does not depend on the atrial fibrillation rhythm presence.

  7. Kronisk iskaemisk hjerteinsufficiens. Revaskularisering bedrer overlevelsen blandt patienter med hibernating myocardium

    DEFF Research Database (Denmark)

    Holdgaard, Paw Chr; Nielsen, Søren Steen; Wiggers, Henrik;

    2007-01-01

    INTRODUCTION: Patients with ischemic heart failure and reversible dysfunctional myocardium (Hibernating myocardium, HIB) can benefit from revascularization. These patients can be selected with nuclear methods. The purpose of this study was to describe the results of the imaging procedures in...

  8. Adjustment and Characterization of an Original Model of Chronic Ischemic Heart Failure in Pig

    Directory of Open Access Journals (Sweden)

    Laurent Barandon

    2010-01-01

    Full Text Available We present and characterize an original experimental model to create a chronic ischemic heart failure in pig. Two ameroid constrictors were placed around the LAD and the circumflex artery. Two months after surgery, pigs presented a poor LV function associated with a severe mitral valve insufficiency. Echocardiography analysis showed substantial anomalies in radial and circumferential deformations, both on the anterior and lateral surface of the heart. These anomalies in function were coupled with anomalies of perfusion observed in echocardiography after injection of contrast medium. No demonstration of myocardial infarction was observed with histological analysis. Our findings suggest that we were able to create and to stabilize a chronic ischemic heart failure model in the pig. This model represents a useful tool for the development of new medical or surgical treatment in this field.

  9. Functional independence in patients with ischemic stroke in the chronic period

    OpenAIRE

    Vasileva, Dance; Lubenova, Daniela

    2013-01-01

    Objective: To investigate the influence of the specialized physical therapy on functional independence and to compare the impact of usual physical therapy in patients with ischemic stroke in the chronic period. Аn indisputable fact is that exercises have a positive contribution to the human body. It is well known that daily physical activities can improve the performance of many systems and organs by increasing its resistance and vital body tone, and also, can significantly improve the abi...

  10. Aging aggravates ischemic stroke-induced brain damage in mice with chronic peripheral infection.

    Science.gov (United States)

    Dhungana, Hiramani; Malm, Tarja; Denes, Adam; Valonen, Piia; Wojciechowski, Sara; Magga, Johanna; Savchenko, Ekaterina; Humphreys, Neil; Grencis, Richard; Rothwell, Nancy; Koistinaho, Jari

    2013-10-01

    Ischemic stroke is confounded by conditions such as atherosclerosis, diabetes, and infection, all of which alter peripheral inflammatory processes with concomitant impact on stroke outcome. The majority of the stroke patients are elderly, but the impact of interactions between aging and inflammation on stroke remains unknown. We thus investigated the influence of age on the outcome of stroke in animals predisposed to systemic chronic infection. Th1-polarized chronic systemic infection was induced in 18-22 month and 4-month-old C57BL/6j mice by administration of Trichuris muris (gut parasite). One month after infection, mice underwent permanent middle cerebral artery occlusion and infarct size, brain gliosis, and brain and plasma cytokine profiles were analyzed. Chronic infection increased the infarct size in aged but not in young mice at 24 h. Aged, ischemic mice showed altered plasma and brain cytokine responses, while the lesion size correlated with plasma prestroke levels of RANTES. Moreover, the old, infected mice exhibited significantly increased neutrophil recruitment and upregulation of both plasma interleukin-17α and tumor necrosis factor-α levels. Neither age nor infection status alone or in combination altered the ischemia-induced brain microgliosis. Our results show that chronic peripheral infection in aged animals renders the brain more vulnerable to ischemic insults, possibly by increasing the invasion of neutrophils and altering the inflammation status in the blood and brain. Understanding the interactions between age and infections is crucial for developing a better therapeutic regimen for ischemic stroke and when modeling it as a disease of the elderly.

  11. Modern View of a Myocardium Restimulation in Patients with a Stable Stenocardia Combined with a Chronic Obstructive Disease of Lungs

    Directory of Open Access Journals (Sweden)

    Grigorieva N.Yu.

    2010-12-01

    Full Text Available Aim of investigation is a study of the heart right and left department state as well as a central intracardiac hemodynamics in patients with a chronic ischemic heart disease (IHD with attendant chronic obstructive disease of lungs (ChODL according to the echodoplercardiography data. Materials and Methods. 389 patients are examined. The 1st group is presented by patients with a stable stenocardia (SS combined with a ChODL. The patients with a SS and ChODL were included into the 2nd and 3d groups respectively. Results. The heart left department sizes in patients of the 1st group were trustworthy greater than in the 2nd and 3d groups. The trustworthy signs of the left ventricle and interventricular septum hypertrophy are revealed in them. A statistically significant difference of the right auricle size in these patients compared to the 2nd group (p=0.003 and 3d group (p=0.005 is established. The left ventricle diastolic dysfunction signs were in patients of all the investigated groups. A pulmonary artery average pressure level in the 1st group was trustworthy higher than in the 2nd group (p<0.001 and 3d group (p=0.009. Conclusion. A more complicated reconstruction of the heart chambers, directed to their hypertrophy and dilatation, takes place at a stable stenocardia combined with a ChODL compared to isolated flow of these diseases; the more expressed alterations of the heart diastolic function appear, a pressure in a pulmonary artery system is increased.

  12. Arteriosclerotic changes in the myocardium, lung, and kidney in dogs with chronic congestive heart failure and myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Falk, Bo Torkel; Jönsson, Lennart; Olsen, Lisbeth Høier;

    2006-01-01

    Background: The occurrence of small vessel arteriosclerosis in the myocardium, kidney, and lung in dogs with naturally occurring myxomatous mitral valve disease has not been previously investigated systematically. Methods: Twenty-one dogs with naturally occurring congestive heart failure and 21 age......-matched, sex-matched, and weight-matched control dogs underwent extensive pathological and histopathological examination. Morphometry and scoring of tissue sections were used to measure arterial narrowing and fibrosis in the myocardium, kidney, and lung; and intimal thickness and plaque formation in the aorta...... and pulmonary artery. Results: Dogs with congestive heart failure had significantly more arterial narrowing in the left ventricle (Pdogs. However...

  13. Chronic oral pathology and ischemic heart disease and its complications

    Directory of Open Access Journals (Sweden)

    Ivaschenko Y.Y.

    2013-09-01

    Full Text Available Objective: to establish the relationship of chronic generalized periodontitis, multiple cavities and dentofacial anomalies with various forms of coronary heart disease and its complications. Material and methods. The study included 294 patients with coronary heart disease and its complications. The patients were divided into two groups. Group I included 89 patients with acute Q-myocardial infarction, which was placed in the presence of at least 2 of the following criteria identified on the basis of a comprehensive clinical and instrumental examination: clinical, laboratory confirmation (CK-MB, electrocardiographic signs of damage or myocardial necrosis. The following statistical methods were used: multi-variate and univariate analysis of variance, non-parametric tests, crosstabulation, chi-square test, Fisher»s exact test. As a measure of variability of the normal distribution standard deviation was used. Results. It is noted that in patients with myocardial infarction more likely than in patients without coronary heart attack in history severe generalized periodontitis, dentofacial anomalies and multiple dental caries have appeared. In patients with acute myocardial infarction, severe periodontal disease has been associated with increased fibrinogen levels in the blood and an increase in the dispersion of the interval QT, which are known to be indicators of poor prognosis in acute coronary disease.

  14. Transient ischemic stunning of the myocardium in stress thallium-201 gated SPET myocardial perfusion imaging: segmental analysis of myocardial perfusion, wall motion and wall thickening changes

    Energy Technology Data Exchange (ETDEWEB)

    Santiago, Jonas Francisco Y.; Heiba, Sherif I.; Abdel-Dayem, Hussein M. [Nuclear Medicine Service, Department of Radiology, St. Vincent' s Catholic Medical Centers of New York, 153 West 11 Street, New York, NY 10011 (United States); Jana, Suman [Department of Endocrinology, St. Vincent' s Catholic Medical Centers of New York (United States); Mirzaitehrane, Majid [Department of Cardiology, St. Vincent' s Catholic Medical Centers of New York (United States); Dede, Fuat [Nuclear Medicine Fellow, Turkish Science Foundation, Marmara University, Ankara (Turkey)

    2002-08-01

    Prolonged and persistent myocardial stunning has recently been demonstrated using technetium-99m sestamibi gated single-photon emission tomography (SPET) myocardial perfusion imaging post exercise or pharmacological stress test. In this study, we investigated the early postischemic transient myocardial stunning on early and delayed poststress thallium-201 gated SPET myocardial perfusion imaging using segmental wall motion (WM) and wall thickening (WT) analysis. A total of 1,680 segments from 84 patients' studies (53 men and 31 women, mean age 60 years) were evaluated on both early and delayed thallium-201 gated SPET treadmill exercise (59) or dobutamine stress (25) myocardial perfusion imaging. Semiquantitative analysis of perfusion, WM and WT in all segments was performed by two observers. Segments were classified according to changes in WM and WT between early and delayed images into normal, fixed abnormality, or improved abnormality (transient stunning), and were further classified according to changes in perfusion into normal, fixed defects, or ischemic. There were significant correlations between perfusion and WM, perfusion and WT, and WM and WT segmental scores on both early and delayed images. Transient stunning was seen significantly (P<0.001) more often in ischemic segments than were normal or fixed perfusion defects using WM (58%) and WT (50%) assessments. There was also a significant correlation between the severity of ischemia and transient stunning with either WM (P<0.05) or WT (P<0.005) evaluation. Segmental myocardial contractility assessment from gated SPET {sup 201}Tl myocardial perfusion imaging using WM and WT was comparable, and results correlated well with the myocardial perfusion assessment. Early transient myocardial stunning was frequently observed in ischemic segments and was related to the severity of myocardial ischemia. (orig.)

  15. Effect of pharmaceutical intervention on AT1R, AT2R, ERK and JNK activity in chronic hibernating myocardium in rabbits

    Institute of Scientific and Technical Information of China (English)

    Dongye Li; Weiwei Li; Yong Xia; Wenhao Qian; Hong Zhu; Tongda Xu; Defeng Pan

    2008-01-01

    Objective: To investigate in chronic hibernating myocardium in rabbits and the influence and significance of captopril, betaloc,valsartan in angiotensin Ⅱ subtype 1 receptor(AT1R), angiotensin Ⅱ subtype 2 receptor(AT2R), extracellular signal regulated kinase 1/2 (ERK1/2), c-Jun N-terminal kinase(JNK). Methods: The model of chronic hibernating myocardium(CHM) was established.The changes of AT1R, AT2R, ERK1/2, JNK in different groups were assessed by western blotting and immunohistochemistry. Results:The amount of AT1R decreased while AT2R increased in the CON group compared with in sham group, and both AT1R and AT2R decreased in drug groups compared with the CON group. The content of ERK had no change in each group, while that of "expression" p-ERK increased in CON group compared with in sham group, and was lower in drug intervention groups than in CON and sham groups. The contents of JNK and p-JNK decreased in CON and drug intervention groups compared with in sham group. The protein levels of JNK, p-JN K in drug intervention groups were lower than in the CON group. Three drugs can inhibit interstitial fibrosis and reduce apoptotic cells. The expression levels in the groups(with different doses) had statistical difference as well as between groups of captopril and other drugs; however the results between betaloc and valsartan had no significant difference. Conclusion: AT1R, AT2R may be the upper stream receptor of ERK and JNK and may participate in generation and evolution of CHM. Captepril, valsartan and betaloc may preserve CHM by inhibiting AT1R, AT2R and JNK activity.

  16. Novel topical formulation for ischemic chronic wounds. Technological design, quality control and safety evaluation.

    Science.gov (United States)

    Cabrera, Carla Agostina; Ramos, Alberto Nicolas; Loandos, María Del Huerto; Valdez, Juan Carlos; Sesto Cabral, Maria Eugenia

    2016-01-01

    Ulceration of the foot in diabetes is common and disabling, and frequently leads to amputation of the leg. The pathogenesis of foot ulceration is complex, clinical presentation variable and management requires early expert assessment. Despite treatment, ulcers readily become chronic wounds. Chronic wounds are those that remain in a chronic inflammatory state failing a normal healing process patterns. This is partially caused by inefficient eradication of opportunistic pathogens like Pseudomonas aeruginosa. We propose its control or eradication will promote wound healing. Lactobacillus plantarum cultures supernatants (LAPS) shows antipathogenic and pro-healing properties. The main objective was to design two pharmaceutical dosage forms by using LAPS as active pharmaceutical ingredient and to perform its quality control, in vitro activity conservation tests and human trials (safety evaluation). Both selected formulations reach the technological quality expected for 120 days, shows adequate occlusive characteristics and proper adhesion to human skin. From the in vitro release assays were found that LAPS shows adequate release from matrix and maintain its antimicrobial and anti-biofilm activity. First human trials were developed and neither edema nor erythema on healthy skin voluntaries was found. We conclude that C80 and C100 are adequate for their use in future clinical trials to demonstrate a comprehensive therapeutic effectiveness in ischemic chronic wounds.

  17. Overlap and distinctiveness of psychological risk factors in patients with ischemic heart disease and chronic heart failure

    DEFF Research Database (Denmark)

    Pelle, Aline J; Denollet, Johan; Zwisler, Ann-Dorthe;

    2009-01-01

    Growing evidence supports the importance of psychological factors in the etiology and progression of cardiovascular disease (CVD). However, this research has been criticized due to overlap between psychological constructs. We examined whether psychological questionnaires frequently used...... in cardiovascular research assess distinct constructs in a mixed group of ischemic heart disease (IHD) and chronic heart failure (CHF) patients....

  18. Effects of Exhaustive Exercise on Myocardium with Hypoxic-Ischemic Injury in Rats%力竭性运动对大鼠心肌缺血缺氧的影响

    Institute of Scientific and Technical Information of China (English)

    潘忠勉; 李杰; 李翠霞; 杨枝创

    2013-01-01

    Objective To study the effects of exhaustive exercise on myocardium with hypoxic-ischemic injury in rats.Methods Forty-five healthy male SD rats were randomly divided into three groups ,each group of 15 rats.The rats in the sedentary control group were bred routinely for 2 weeks and did not swim.The rats in the right after exhaustive exercise group and 48 hours after exhaustive exercise group conducted exhaustive weight -loading swimming once a day for two weeks.The rats were killed and then treated with HBFP staining after the last exhaustive exercise in right after exhaustive exercise group as well as 48 hours after the exercise in the 48 hours after exhaustive exercise group .Results There were significant myocardial hypoxic-ischemic areas in the two exhaustive exercise groups ,and unevenly stained myocardial fibers were observed ,there were more spot-like or flake red hypoxic-ischemic areas in the cytoplasm .The hypoxic-ischemic area and mean optical density (MOD) in the 48 hours after exhaustive exercise group were larger than those in the right after exhaustive exercise group (P<0.05).Both myocardial ischemia anoxic area and MOD were 0 in the control group.Conclusion The exhaustive exercise may lead to myocardial injury which may be delayed .%  目的观察力竭性运动对大鼠心肌缺血缺氧性损伤形态的影响。方法健康雄性SD大鼠45只,随机分为3组,每组15只。安静对照组常规饲养2周,不游泳;力竭性运动后即刻组及力竭性运动后48 h组每天均进行一次负重性力竭性游泳,连续2周。力竭性运动后即刻组在最后一次运动后即刻,力竭性运动后48 h组在运动后48 h处死大鼠取材并进行HBFP染色。结果力竭性运动的两组均出现明显的心肌缺血缺氧区域;心肌纤维着色均不均匀,细胞质内有较多斑点状或者片状的大红色缺血缺氧区域;力竭性运动后48 h组缺血缺氧面积及光密度值(MOD)均大于力

  19. Ischemic postconditioning protects hypertrophic myocardium by ERK1/2 signaling pathway: experiment with mice%肥厚心肌缺血后适应时细胞外信号调节激酶的保护作用

    Institute of Scientific and Technical Information of China (English)

    李晓梅; 马依彤; 杨毅宁; 张健发; 陈邦党; 刘芬; 黄莺; 韩伟; 高晓明

    2009-01-01

    Objective To investigate the effects of ischemic postconditioning (IPest) in protecting hypertrophic myocardium subjected to ischemic-reperfusion (I/R) and to study the role of extracellular regulated protein kinase (ERK1/2) in mediating such protection. Methods Transverse aortic constriction (TAG) operation was performed on 12-week-old C57/BL mice to establish left ventricular hypertrophy models. Sixty-four isolated TAG mouse hearts were mounted onto the Langendorff perfusinn system and randomly divided into 4 equal group: (1) I/R group undergoing stable perfusion for 30 rain, ischemia for 30 min, and re-perfusion for 120 min (an I/R cycle) to cause hypertrophic myocardium I/R injury, (2) IPost group undergoing ischemia for 10s and reperfusion for 10s, totally 3 cycles (60s) before reperfusion for 120 rain, (3) I/R + PD98059 (an ERK1/2 inhibitor) group undergoing perfusion of Krebs-Henseleit(KH) buffer with PD98059 10-5>mol/L for 15 min and perfusion of KH buffer without PD98059 at the beginning of re-perfusion, and (4) IPost + PD98059 group undergoing 3 cycles of IPost and perfusion of KH buffer with PD98059 10-5mol/L for 15 min at the beginning of re-perfusion. Hemodynamic examination was conducted 120 min after re-perfusion to measure the left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), maximal uprising velocity of left ventricle pressure (dp/dtmax), and minimal uprising velocity of left ventricle pressure (dp/dtmin). After the I/R procedure the mvocardium of the left ventricle was isolated to detect the infarction size (IS). Weetem blotting was used to detect the protein expresson of extracellular signal-regulated kinase (ERK) 1/2, phospharylated ERK1/2, Bcl-2, Bax, and mitochondrial and cytosolic eytochrome (Cyt). C. TUNEL was used to detect the apoptotic rate. Results The LVSP and dp/dtmaxlevels of the IPost group were(85 ±4)mm Hg and (3811±230) mm Hg/s, both significantly higher than those of the I/R group [(68

  20. 再灌注抢救激酶在肥厚心肌缺血后适应中的作用%Ischemic postconditioning protects hypertrophic myocardium by reperfusion injury salvage kinase in mice

    Institute of Scientific and Technical Information of China (English)

    李晓梅; 杨毅宁; 马依形; 陈邦党; 刘芬; 韩伟; 高晓明

    2011-01-01

    目的 探讨再灌注抢救激酶细胞外信号调节激酶1/2(ERK1/2 )和磷脂酸肌醇3激酶-蛋白激酶B(PI3 K-Akt)信号通路在缺血后适应(Most )对减轻肥厚心肌缺血再灌注(I/R)损伤中的作用.方法 12周龄C57/BI刁、鼠通过主动脉弓缩窄4周建立心肌肥厚模型,利用Langendor"灌流装置建立小鼠肥厚心肌I/R模型,30 min全心缺血随后再灌注15、120 min.分为缺血再灌注组(I/R组)、后适应组(Most组,采取缺血10 s及再灌注10s的3次Most周期),I/R+抑制剂组[分别加人ERK1/2特异性抑制剂PD98058,Akt特异性抑制剂握曼青霉素(wortmannin)],IPost+抑制剂组,进行心脏血流动力学检测,采用三苯基氯化四氮哇染色的方法确定心肌梗死范围,免疫印迹方法检测ERK1/2,p70s6k,Akt、糖原合成酶3阿GSK-3团总蛋白及磷酸化蛋白表达水平.结果 与I/R组比较,Most组小鼠心脏血流动力学指标左心室收缩压、左室压力上升最大速度显著改善[(67±5)比(86±6),(2720±210)比(3678±330)mm Hg,均P0.05);Most+PD98058组显示在再灌注的最初15 min使用PD98059能消除Most对肥厚心肌的上述保护作用.与I/R组比较,IPost组再灌注15、120 min心肌的Akt,GSK-3β蛋白磷酸化水平表达差异无统计学意义(均P>O.05);I/R+wortmannin组、IPost+wortmannin组上述指标差异亦无统计学意义(均P>O.05).结论 IPost能有效地减轻离体小鼠肥厚心肌缺血再灌注损伤,ERK1 /2细胞信号途径是IPost对缺血再灌注肥厚心肌保护作用的重要信号通路;而PI3K-Akt信号通路未参与IPost上述保护作用.%Objective To determine the effect of ischemic postconditioning (IPost) protection in hypertrophic myocardium subjected to ischemic-reperfusion (I/R) injury and to study the role of reperfusion injury salvage kinase (RISK) in mediating such protection. Methods Transversing aortic constriction (TAC) was induced for 4 weeks in 12 weeks old C57/BL mice to establish left ventricular hypertrophy

  1. Impaired cerebral autoregulation is associated with brain atrophy and worse functional status in chronic ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Mikio C Aoi

    Full Text Available Dynamic cerebral autoregulation (dCA is impaired following stroke. However, the relationship between dCA, brain atrophy, and functional outcomes following stroke remains unclear. In this study, we aimed to determine whether impairment of dCA is associated with atrophy in specific regions or globally, thereby affecting daily functions in stroke patients.We performed a retrospective analysis of 33 subjects with chronic infarctions in the middle cerebral artery territory, and 109 age-matched non-stroke subjects. dCA was assessed via the phase relationship between arterial blood pressure and cerebral blood flow velocity. Brain tissue volumes were quantified from MRI. Functional status was assessed by gait speed, instrumental activities of daily living (IADL, modified Rankin Scale, and NIH Stroke Score.Compared to the non-stroke group, stroke subjects showed degraded dCA bilaterally, and showed gray matter atrophy in the frontal, parietal and temporal lobes ipsilateral to infarct. In stroke subjects, better dCA was associated with less temporal lobe gray matter atrophy on the infracted side ([Formula: see text] = 0.029, faster gait speed ([Formula: see text] = 0.018 and lower IADL score ([Formula: see text]0.002. Our results indicate that better dynamic cerebral perfusion regulation is associated with less atrophy and better long-term functional status in older adults with chronic ischemic infarctions.

  2. CHRONIC HEART FAILURE OF ISCHEMIC GENESIS AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE: POSSIBILITIES OF COMBINATION THERAPY INCLUDING NEBIVOLOL

    Directory of Open Access Journals (Sweden)

    P. A. Fedotov

    2014-07-01

    Full Text Available Objective: to reveal the features of chronic heart failure (CHF of ischemic genesis concurrent with chronic obstructive pulmonary disease (COPD and to investigate the effect of the cardioselective β1-adrenoblocker (β1-AB nebivolol on the course of COPD and the parameters of the bronchopulmonary system in patients with CHF of ischemic genesis during treatment.Subjects and methods.The investigation enrolled 63 patients aged 40–70 years, including 43 patients with functional class (FC II–IV CHF with a Simpson left ventricular ejection fraction of  45 % concurrent with COPD (a study group and 20 patients with CHF and no bronchopulmonary pathology (a control group. The study group patients were randomly divided into 2 subgroups: 1 23 patients who received nebivolol in addition to background therapy; 2 20 patients in whom the therapy ruled out the use of β1-AB. The control patients were switched to nebivolol therapy. During 6-month follow-up, the authors made clinical examination, recorded the rate, duration, and severity of COPD exacerbations, performed a 6-minute walking test (6MWT, and used a clinical status scale modified by R. Cody, a dyspnea 0–10 category ratio (Borg scale, and a Medical Research Council Dyspnoea Scale (MRS scale. Besides, quality of life in patients was assessed using the specific Minnesota Living with Heart Failure Questionnaire. All the patients underwent echocardiography, bronchodilatation-induced external respiratory function test, peak flowmetry, and blood brain natriuretic peptide quantification. These studies were conducted at baseline and at 1 and 6 months of therapy.Results. During the investigation, the patients with CHF concurrent with COPD were found to have a high rate of hypertensive disease, prior myocardial infarctions, atrial fibrillations, and higher FC exertional angina. These patients also showed a delayed optimal result achievement during the combination therapy involving the use of β1-AB

  3. Chronic ischemic mitral regurgitation and papillary muscle infarction detected by late gadolinium-enhanced cardiac magnetic resonance imaging in patients with ST-segment elevation myocardial infarction

    NARCIS (Netherlands)

    Bouma, Wobbe; Willemsen, Hendrik M; Lexis, Chris P H; Prakken, Niek H; Lipsic, Erik; van Veldhuisen, Dirk J; Mariani, Massimo A; van der Harst, Pim; van der Horst, Iwan C C

    2016-01-01

    BACKGROUND: Both papillary muscle infarction (PMI) and chronic ischemic mitral regurgitation (CIMR) are associated with reduced survival after myocardial infarction. The influence of PMI on CIMR and factors influencing both entities are incompletely understood. OBJECTIVES: We sought to determine the

  4. hVEGF165/Ang-1联合转染对兔缺血心肌血管再生的影响%The effect of combination of hVEGF165/Ang-1 gene transfection on angiogenesis in rabbit ischemic myocardium

    Institute of Scientific and Technical Information of China (English)

    陈李李; 袁延亮; 董红燕; 张中明; 张昊; 王正

    2012-01-01

    Objective To test the effect of combination of vascular endothelial growth factor ( VEGF) and angiopoi-etin - 1 (Ang -1) gene transfection on angiogenesis and vascular maturation in ischemic myocardium . Methods The rabbit model of myocardial ischemia was established by ligating the left ventricular anterior descending coronary artery branch. The experimental animals were ramdomly divided into 5 groups (re =5 each) ; AVEGF165/Ang - 1 double - gene group ( group A ) , AVEGF165 single - gene group ( group B ) , Ang - 1 single - gene group ( group C ) , infarct group (group D) , normal control group (group E). Target genes were transferred to ischemic myocardium by direct intramus -cular injection. Angiogenesis and vascular maturation during ischemic myocardium were observed in each group using im - munofluorescence staining. Results Fitc - lectin and a - SMA positive vessels were significantly increased in group A compared to groups B , C and D (P <0.05). Conclusion Compared to single gene transfection , combination of VEGF and Ang -1 gene transfection can enhance the angiogenesis in ischemic area of myocardium in rabbits .%目的 探讨VEGF/Ang-1基因联合转染对缺血心肌区域血管再生及血管成熟的影响.方法 建立兔心肌缺血模型,实验动物随机分为5组(每组5只):hVEGF165/Ang-1双基因联合转染组(A组),hVEGF165单基因转染组(B组),Ang-1单基因转染组(C组),单纯梗死组(D组),正常对照组(E组).冠状动脉左前降支(LAD)结扎后在缺血心肌区域直接注射的方法转染 rAAV-9HRE-hVEGF165和(或)rAAV-TRE-Tight-Ang-1;Fitc-lectin和α-SMA免疫荧光染色,观察缺血心肌区域血管新生及成熟情况.结果 与B、C、D组相比,A组Fitc-lectin和α-SMA阳性血管数量显著增多(P<0.05).结论 与单一促血管生成基因转染比较,hVEGF165/Ang-1双基因联合转染可改善兔心肌梗死区域血管再生.

  5. 无创肢体缺血预处理对兔心肌电稳定性的影响及机制%Effects and mechanism of non-invasive limb ischemic preconditioning on electrical stability of rabbits myocardium.

    Institute of Scientific and Technical Information of China (English)

    侯丽芳; 冯志强; 肖业伟; 冉兵; 余广; 盘强文

    2011-01-01

    目的 探讨无创肢体缺血预处理(LIP)对兔心肌电稳定性的影响及其机制.方法 取兔27只,随机分为:单纯缺血对照组(Ctr组),LIP组,LIP+ ATP敏感的钾通道(KATP)抑制剂格列苯脲组(LG组),LIP+丝裂素活化的蛋白激酶(p38MAPK)抑制剂SB203580组(LSB组),闭胸状态下同步记录体表ECG及心内、外膜单相动作电位.分析心肌缺血背景下单相动作电位振幅(MAPA)、单相动作电位复极90%时间(APD9o)、0期去极化最大速率(Vmax)和心率、心律失常的类型、发生率及持续时间的变化,实验结束后取心肌组织检测其中超氧化物歧化酶(SOD)、丙二醛(MDA)及一氧化氮(N0)含量.结果 缺血后,四组的平均心率、MAPA、Vmax均不同程度地减小,APD90不同程度地延长;LIP能抑制心律失常的发生,使心律失常持续时间缩短.LG组心律失常发生降低,持续时间缩短,LSB组结果 与Ctr组相近.与Ctr组比较,LIP组SOD活力升高;其余三组的MDA含量降低;LIP组NO含量升高,而LG组及LSB组亦低于LIP组(P均<0.05).结论 无创肢体缺血预处理具有增强兔心肌电稳定性、减轻心肌氧化损伤的作用,p38MAPK可能为其发挥保护作用的重要途径,KATP则可能仅在抗氧化和改善供血等方面发挥了作用.%Objective To investigate the effects and mechanism of non-invasive limb ischemic preconditioning! LIP) on electrical stability of rabbits myocardium. Methods Twenty-seven rabbits were randomly divided into: ischemia control group (Ctr group), LIP group, LIP + KATP inhibitor glibenclamide group ( LG group), LIP + p38MAPK inhibitor SB203580 group (LSB group). Surface ECG , endocardium and epicardiura MAP were recorded simultaneausly in closed-chest state. In the context of myocardial ischemia,the monophasic action potential amplitude(MAPA) , action potential duration of 90% (APDW) .maximal rate of depolarization( Vmax) heart rate.the type of arrhythmia, incidence and duration of changes

  6. Fetal stem cells in combined treatment of chronic heart failure and their effect on morphofunctional parameters of the left ventricle myocardium and cognitive functions

    Directory of Open Access Journals (Sweden)

    Klunnyk MO

    2014-08-01

    Full Text Available Mariya O Klunnyk, Nataliia S Sych, Irina G Matiyashchuk, Olena V Ivankova, Marina V Skalozub Cell Therapy Center EmCell, Kyiv, Ukraine Aim: To investigate the effect of combined treatment with the inclusion of fetal stem cells (FSCs on the morphology and functional dynamics of the left ventricle and cognitive functions in patients with chronic heart failure (CHF. Materials and methods: A comparative study was carried out on patients with CHF to examine the effect of combined treatment, including the experimental application of FSCs, on the morphofunctional parameters of the left ventricle and cognitive functions. Patients were examined before FSC treatment (FSCT, and 1 month, 3 months, and 6 months after treatment. The control group consisted of 20 CHF patients of similar age, sex, and New York Heart Association class. Results: It has been proven that FSCs positively affect objective and subjective clinical parameters. A significant reduction of serum type B brain natriuretic peptide was reported as early as 1 month after treatment. Significant increases in the left ventricle ejection fraction and decreases of the end diastolic volume were observed 6 months after treatment. Cognitive performance tests showed improvements on the Mini-Mental State Examination and Frontal Assessment Battery (conceptualization, mental flexibility, programming, sensitivity to interference, inhibitory control, and environmental autonomy scales. The treatment resulted in significant improvements in the general score and across all cognitive areas of the Mini-Mental State Examination (recall, orientation, attention, calculation, and complex commands after 3 months, and significant improvements across all Frontal Assessment Battery areas after 6 months. In the control group, these scores showed significant increases only at 6 months after the treatment. In the study group, depression was significantly reduced within 1 month after treatment versus 3 months in the control

  7. Sex differences in the hypertensive population with chronic ischemic heart disease.

    Science.gov (United States)

    Barrios, Vivencio; Escobar, Carlos; Bertomeu, Vicente; Murga, Nekane; de Pablo, Carmen; Calderón, Alberto

    2008-10-01

    Cardiopatía Isquémica Crónica e Hipertensión Arterial en la Práctica Clínica en España (CINHTIA) was a survey designed to assess the clinical management of hypertensive outpatients with chronic ischemic heart disease. Sex differences were examined. Blood pressures (BP) was considered controlled at levels of <140/90 or <130/80 mm Hg in diabetics (European Society of Hypertension/European Society of Cardiology 2003); low-density lipoprotein cholesterol (LDL-C) was considered controlled at levels <100 mg/dL (National Cholesterol Education Program Adult Treatment Panel III). In total, 2024 patients were included in the study. Women were older, with a higher body mass index and an increased prevalence of atrial fibrillation. Dyslipidemia, smoking, sedentary lifestyle, and peripheral arterial disease were more frequent in men. In contrast, diabetes, left ventricular hypertrophy, and heart failure were more common in women. BP and LDL-C control rates, although poor in both groups, were better in men (44.9% vs 30.5%, P<.001 and 33.0% vs 25.0%, P<.001, respectively). Stress testing and coronary angiography were more frequently performed in men.

  8. MAGNESIUM METABOLISM AND CLINICAL CHARACTERISTICS OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    A. V. Yezhov

    2010-01-01

    Full Text Available Aim. To study relationship of the clinical state and cardiac functional parameters with magnesium metabolism indices in patients with chronic ischemic heart disease (IHD.Material and methods. Patients with stable angina pectoris, II-III class (n=480 were involved into the study. Evaluation of the following items was performed: disease course, anxiodepressive syndrome intensity, exercise tolerance, blood and urine electrolyte profile, systolic and diastolic left ventricle function, endothelium-dependent and endotheliumnondependent vasodilatation, i/v magnesium load test, Holter electrocardiogram monitoring.Results. High prevalence of systemic magnesium deficiency (17.9 and 37.5% according to serum and erythrocyte levels, respectively was found in IHD patients. Severity of magnesium deficiency in IHD patients depended on duration of disease, experience of myocardial infarction, myocardial ischemia seriousness, disorders of endothelium vasodilating function and left ventricle diastolic function, severity of concomitant anxiety. Exercise tests were changed in IHD patients with magnesium deficiency.Conclusion. The study data let to consider that magnesium deficiency involves into the IHD pathogenesis.

  9. Characterization of the asynergic myocardium in acute coronary syndrome using simultaneous dual radionuclide emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Sone, Takahito; Tsuboi, Hideyuki; Sassa, Hiromi; Okumura, Yasuki (Ogaki Municipal Hospital, Gifu (Japan))

    1991-01-01

    Phantom and clinical studies were undertaken to determine the value of dual SPECT with Tl-201 and Tc-99m pyrophosphate using a simultaneous collection method in evaluating tissue characterization of ischemic myocardium. Phantom experiments revealed that the residual myocardium was detected from the severity of Tl-201 defect images; the influence of cross talk between two radionuclides was negligible; when the Tc-99m layer was located within 50% inside the phantom wall and the other space was filled with Tl-201 solution, the Tc-99m layer was visualized inwardly more clearly than the Tl-201 layer; and transmural infarction 2 to 2.5 cm in diameter was visualized as the total defect of Tl-201. Taking these results into account, scintigraphic characteristics in 84 patients with acute coronary syndrome were evaluated. Seventeen patients in whom asynergy had nearly resolved in the chronic phase were defined as the group of reversible ischemic myocardial damage. Tl-201 uptake in ischemic lesions was improved in the chronic phase when reinfarction was not seen. Both reduced uptake of Tl-201 and Tc-99m uptake in the subendocardial segment were seen in 43% for nontransmural infarction. Total defect of Tl-201 along with transmural uptake of Tc-99m was the most common for transmural infarction. For unstabler angina pectoris, there was no evidence of Tc-99m PYP uptake. Reduced or normal uptake of Tl-201 combined with negative Tc-99m uptake were dominant for reversible ischemic myocardial damage. Patients having relatively good recovery had a significantly higher prevalence of reduced Tl-201 uptake and subendocardial uptake of Tc-99m and a significantly lower prevalence of the total defect of Tl-201 and transmural uptake of Tc-99m. In conclusion, dual SPECT is useful for predicting reversibility in the early stage of acute coronary syndrome. (N.K.).

  10. Proteomic analysis identifies mitochondrial metabolic enzymes as major discriminators between different stages of the failing human myocardium

    DEFF Research Database (Denmark)

    Urbonavicius, Sigitas; Wiggers, Henrik; Bøtker, Hans Erik;

    2009-01-01

    Our aim was to identify patterns in differentially regulated proteins associated with the progression of chronic heart failure. We specifically studied proteomics in chronic reversibly (RDM) and irreversibly dysfunctional myocardium (IRDM), as well as end-stage failing myocardium (ESFM)....

  11. 自体内皮前体细胞移植促缺血心肌血管新生的实验%Implantation of autologous murine endothelial progenitor cells promotes neovascularization in ischemic myocardium

    Institute of Scientific and Technical Information of China (English)

    邢泉生; 泮思林; 孙龙

    2007-01-01

    BACKGROUND: Under certain condition, circulating endothelial progenitor cells (EPCs) can differentiate into endothelial cells, and further participate in angiogenesis.OBJECTIVE: The goal of this study was to investigate the feasibility and efficacy of peripheral blood-derived EPCs in promoting angiogenesis in the ischemic myocardium, in order to provide a new cell implanting method for the treatment of coronary heart disease.DESIGN: A randomized controlled experiment.MATERIALS: Sixty male Sprague-Dawley (SD) rats, of clean grade, weighing (340±20) g, were provided by Qingdao Laboratory Animal Center. These animals were randomly divided into 2 groups with 30 rats in each: experimental group and control group. In each group, ten rats were separately observed 2, 4 and 8 weeks after EPCs being injected. The protocol was conducted in accordance with animal ethics guidelines for the use and care of animals.METHODS: This study was carried out in the Qingdao Key Laboratory of Medical Biological Technology between May 2003 and September 2004. After SD rats in the experimental group were anesthetized, peripheral blood was taken.Mononuclear cells were harvested by density gradient centrifugation. CD31, CD34, Flk-1 and von Willebrand disease factor immunofluorescence staining positive EPCs were harvested by adding the defined media of vascular endothelial growth factors and basic fibroblast growth factor. Myocardial ischemia was induced by ligation of murine left anterior descending coronary artery. Autologous EPCs isolated from the peripheral blood of each animal were infused to ischemic myocardium. In the control groups,cell culture media were infused, and the other procedures were the same as those in the experimental group. Two, four and eight weeks after ligation, all animals were sacrificed by overdose anesthesia, and heart tissue sections were made.MAIN OUTCOME MEASURES: ①After haematoxylin-eosin staining, myocardial structure changes were observed under an optical

  12. Compromised Blood-Brain Barrier Competence in Remote Brain Areas in Ischemic Stroke Rats at Chronic Stage

    Science.gov (United States)

    Garbuzova-Davis, Svitlana; Haller, Edward; Williams, Stephanie N.; Haim, Eithan D.; Tajiri, Naoki; Hernandez-Ontiveros, Diana G.; Frisina-Deyo, Aric; Boffeli, Sean M.; Sanberg, Paul R.; Borlongan, Cesario V.

    2014-01-01

    Stroke is a life threatening disease leading to long-term disability in stroke survivors. Cerebral functional insufficiency in chronic stroke might be due to pathological changes in brain areas remote from initial ischemic lesion, i.e. diaschisis. Previously, we showed that the damaged blood-brain barrier (BBB) was implicated in subacute diaschisis. The present study investigated BBB competence in chronic diaschisis using a transient middle cerebral artery occlusion (tMCAO) rat model. Our results demonstrated significant BBB damage mostly in the ipsilateral striatum and motor cortex in rats at 30 days after tMCAO. The BBB alterations were also determined in the contralateral hemisphere via ultrastructural and immunohistochemical analyses. Major BBB pathological changes in contralateral remote striatum and motor cortex areas included: (1) vacuolated endothelial cells containing large autophagosomes, (2) degenerated pericytes displaying mitochondria with cristae disruption, (3) degenerated astrocytes and perivascular edema, (4) Evans Blue extravasation, and (5) appearance of parenchymal astrogliosis. Importantly, discrete analyses of striatal and motor cortex areas revealed significantly higher autophagosome accumulation in capillaries of ventral striatum and astrogliosis in dorsal striatum in both cerebral hemispheres. These widespread microvascular alterations in ipsilateral and contralateral brain hemispheres suggest persistent and/or continued BBB damage in chronic ischemia. The pathological changes in remote brain areas likely indicate chronic ischemic diaschisis, which should be considered in the development of treatment strategies for stroke. PMID:24610730

  13. Long-term expression of periostin during the chronic stage of ischemic stroke in mice.

    Science.gov (United States)

    Shimamura, Munehisa; Taniyama, Yoshiaki; Nakagami, Hironori; Katsuragi, Naruto; Wakayama, Kouji; Koriyama, Hiroshi; Kurinami, Hitomi; Tenma, Akiko; Tomioka, Hideki; Morishita, Ryuichi

    2014-06-01

    Periostin is an extracellular matrix glycoprotein and has various cellular effects. Previously, we demonstrated the neuroprotective effects of periostin during the acute stage of cerebral ischemia. However, its expression during the chronic stage remains unknown. Herein, we examined the expression of full-length periostin (periostin 1; Pn1) and its splicing variant lacking exon 17 (periostin 2; Pn2) during the 28 days following transient middle cerebral artery occlusion in mice. Real-time reverse transcription-PCR showed that the expression of Pn2 was dramatically upregulated between days 3 and 28, and the highest expression was observed on day 7. The expression of Pn1 was also increased, but delayed compared with Pn2. Immunohistochemistry showed that periostin was weakly expressed in reactive astrocytes in the peri-infarct region and in microglia/macrophages in infarct regions, on days 3 and 7. Periostin was also expressed around CD31-positive cells in both the peri-infarct and the sub-ventricular zone (SVZ) on days 3 and 7. SOX-2 positive cells, which are neural stem cells, also expressed periostin on day 7. The highest periostin immunoreactivity that occurred co-localized with collagen I and fibronectin in the peri-infarct region between days 7 and 28. Thus, the expression pattern of periostin mRNA was dependent on the splicing variant, and it continued to be expressed up to 28 days after cerebral ischemia. As periostin was expressed in various cells, such as reactive astrocytes/microglia, fibroblasts and neuronal progenitor cells, periostin might be associated with pathophysiology in post-ischemic inflammation and neurogenesis.

  14. Amlodipine versus nifedipine retard in the treatment of chronic ischemic heart disease.

    Science.gov (United States)

    Circo, A; Scaccianoce, G; Platania, F; Castelli, D; Cardillo, R; Mangiameli, S

    1992-01-01

    The efficacy of amlodipine, a long half-life dihydropyridine calcium antagonist, at the dosage of 5-10 mg/day in a single daily administration, has been compared with that of nifedipine R, a short half-life dihydropyridine, at the dosage of 20-40 mg b.i.d. in 29 patients with chronic ischemic heart disease. After a one week placebo period, patients were assigned to the treatment with amlodipine or nifedipine R, according to a randomized sequence and a cross-over, single-blind design, for two control periods of four weeks and without a wash-out interval between these two phases. During the stress test, a significant increase from baseline in test duration and in time to onset of ischemia and of angina have been obtained with both treatments; moreover amlodipine increased significantly the time to onset of ST segment deviation (-1 mm) and the time to maximum ST segment deviation compared with nifedipine R changes. Also with Holter monitoring and in the angina diary there was a significant reduction of anginal episodes. As regards safety profile, amlodipine treatment was associated with a significantly lower incidence of side effects compared with nifedipine R. This is probably due to the particular pharmacokinetics of amlodipine which, besides the long half-life which allows a single daily administration, shows a retarded peak (between the 6th and the 12th hour) with consequent reduction of phenomena connected with fast and excessive peripheral vasodilatation. In conclusion, amlodipine was as effective in reducing the signs of ischemia as nifedipine R, but compliance was better due to the single daily administration and so was tolerability. PMID:1388115

  15. Adiponectin protects rat myocardium against chronic intermittent hypoxia-induced injury via inhibition of endoplasmic reticulum stress.

    Directory of Open Access Journals (Sweden)

    Wenxiao Ding

    Full Text Available Obstructive sleep apnea syndrome (OSAS is associated with many cardiovascular disorders such as heart failure, hypertension, atherosclerosis, and arrhythmia and so on. Of the many associated factors, chronic intermittent hypoxia (CIH in particular is the primary player in OSAS. To assess the effects of CIH on cardiac function secondary to OSAS, we established a model to study the effects of CIH on Wistar rats. Specifically, we examined the possible underlying cellular mechanisms of hypoxic tissue damage and the possible protective role of adiponectin against hypoxic insults. In the first treatment group, rats were exposed to CIH conditions (nadir O2, 5-6% for 8 hours/day, for 5 weeks. Subsequent CIH-induced cardiac dysfunction was measured by echocardiograph. Compared with the normal control (NC group, rats in the CIH-exposed group experienced elevated levels of left ventricular end-systolic dimension and left ventricular end-systolic volume and depressed levels of left ventricular ejection fraction and left ventricular fractional shortening (p<0.05. However, when adiponectin (Ad was added in CIH + Ad group, we saw a rescue in the elevations of the aforementioned left ventricular function (p<0.05. To assess critical cardiac injury, we detected myocardial apoptosis by Terminal deoxynucleotidyl transfer-mediated dUTP nick end-labeling (TUNEL analysis. It was showed that the apoptosis percentage in CIH group (2.948% was significantly higher than that in NC group (0.4167% and CIH + Ad group (1.219% (p<0.05. Protein expressions of cleaved caspase-3, cleaved caspase-9, and cleaved-caspase-12 validated our TUNEL results (p<0.05. Mechanistically, our results demonstrated that the proteins expressed with endoplasmic reticulum stress and the expression of reactive oxygen species (ROS were significantly elevated under CIH conditions, whereas Ad supplementation partially decreased them. Overall, our results suggested that Ad augmentation could improve CIH

  16. Influence of kinesitherapy on motor recovery and functional independence in patients with ischemic stroke in the chronic period

    OpenAIRE

    Vasileva, Dance; Lubenova, Daniela; Mihova, Marija; Grigorova-Petrova, Kristin; Dimitrova, Antoaneta

    2015-01-01

    The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on motor recovery and functional independence in patients with ischemic stroke in the chronic period (ISChP). Material and Methods The study was conducted with 56 patients with ISChP (32 men and 24 women, mean age 63.2 ± 8.8 years old, weight 77.9 ± 10.1 kg, height 169.2 ± 6.4 centimeters and duration of illness up to 1 year). Assessment of motor recovery and the level of functional independence...

  17. Short-term effects of ivabradine in patients with chronic stable ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Hosam Zaky

    2013-01-01

    Full Text Available Introduction: Ivabradine is a novel selective If current inhibitor with anti-ischemic and antianginal activity. Objectives: To assess the effect of the selective If current inhibitor ivabradine on heart rate, angina pectoris, and functional capacity in stable patients with chronic coronary artery disease on maximally tolerated medical therapy. Materials and Methods: Consecutive patients from the out-patient cardiology clinic with stable coronary artery disease documented by coronary angiography were included. Patients had to be on maximally tolerated medical therapy with β-blockers, angiotensin-converting enzyme inhibitors or receptor blockers (ACE-I or ARB, antiplatelets, statins, nitrates, and anti-metabolics with a baseline heart rate of at least 70 beats per minute. All patients underwent assessment of angina (Canadian Cardiovascular Society Angina Class: CCS I to IV and functional capacity (using a validated self-administered questionnaire, at baseline and after 4 months of ivabradine therapy. Results: Twenty patients were enrolled (mean age 47 ± 7 years, all male, 60% with hypertension, 30% with diabetes mellitus. Patients were on optimal medical regimen of aspirin (100%, β-blocker (100%, statins (100%, clopidogrel (90%, nitrates (35%, anti-metabolics (90%, and ACE-I or ARB (95%. At baseline, the majority of patients (90% were in CCS class II-IV. All patients were started on ivabradine 5 mg twice daily, and in 12 patients the dose was increased to 7.5 mg twice daily. After 4 months of treatment, the heart rate was significantly reduced from an average of 82 ± 8 to 68 ± 6 bpm ( P < 0.001. The reduction in heart rate was accompanied by a significant improvement in functional capacity (score 3.5 ± 0.9 to 4.7 ± 0.7, P < 0.001 and angina classification; at baseline 10% of the patients were in CCS class I compared to 50% after 4 months of therapy ( P = 0.01. No symptomatic bradycardia was reported with ivabradine. Conclusion: The addition

  18. Protective effect of Panax quinquefolius saponin on non-ischemic myocardium in myocardial infarction rats%西洋参茎叶总皂苷对心肌梗死大鼠非梗死区组织的保护作用

    Institute of Scientific and Technical Information of China (English)

    郭春雨; 刘倩; 石颖; 刘欣; 张颖

    2012-01-01

    Objective To observe the protective effect of PQS on non-ischemic myocardium in AMI rats. Methods One hudred Wistar rats were included in this study. After a rat AMI modelwas established by ligation of the left anterior ascending coronary artery, the rats were randomly divided into model group,metoprolol group,PQS group,normal control group and sham operation group (20 in each group). Pathological changes in ischemic and non-ischemic myocardial tissues of rats were observed under light microscope. hs-CRP was detected by ELISA. IL-6 and ET-1 levels were measured by radioimmunoassay. Changes in NO were detected with biochemical method. Biological activity of cytochrome C oxidase and ATP synthase was assayed by colorimetry. Pathological changes in renal tissues from normal control and model groups were observed under optical microscope. Results Different extents of inflammatory cell infiltration and myocardial damages such as myocardial fiber distortion were observed in ischemic and non-ischemic myocardium. The hs-CRP, IL-6 and ET-1 levels were significantly lower while the NO level was significantly higher in PQS group and metoprolol group than in model group (P<0. 05,P<0. 01). Light microscopy showed that the renal tissue capillary wall was significantly thicker in model group with more neutrophils and monocytes observed in renal interstitium. Conclusion PQS can protect non-ischemic myocardium against damage following AMI by antagozing inflammatory reaction,protecting blood vessel endothelium and regulating energy metabolim.%目的 观察西洋参茎叶总皂苷(PQS)对急性心肌梗死(AMI)大鼠非梗死区组织的保护作用.方法 选择Wiser大鼠100只建立AMI模型,造模后随机分为模型组20只、美托洛尔组20只、PQS组20只、正常组20只和假手术组20只.光镜观察大鼠缺血及非缺血区心肌组织病理变化;ELISA法检测高敏C反应蛋白含量;放射免疫法检测白细胞介素6、内皮素1水平;硝酸还原酶

  19. Transplanted Bone Marrow Cells Repair Heart Tissue and Reduce Myocarditis in Chronic Chagasic Mice

    OpenAIRE

    MILENA B. P. SOARES; Lima, Ricardo S.; Rocha, Leonardo L.; Takyia, Christina M; Pontes-de-Carvalho, Lain; Campos de Carvalho, Antonio C.; Ribeiro-dos-Santos, Ricardo

    2004-01-01

    A progressive destruction of the myocardium occurs in ∼30% of Trypanosoma cruzi-infected individuals, causing chronic chagasic cardiomyopathy, a disease so far without effective treatment. Syngeneic bone marrow cell transplantation has been shown to cause repair and improvement of heart function in a number of studies in patients and animal models of ischemic cardiopathy. The effects of bone marrow transplant in a mouse model of chronic chagasic cardiomyopathy, in the presence of the disease ...

  20. Cerebral blood flow in acute and chronic ischemic stroke using xenon-133 inhalation tomography

    DEFF Research Database (Denmark)

    Vorstrup, S; Paulson, O B; Lassen, N A

    1986-01-01

    Serial measurements of cerebral blood flow (CBF) were performed in 12 patients with acute symptoms of ischemic cerebrovascular disease. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. Six patients had severe strokes and large infarcts on the CT scan. They...

  1. Sex-dependent effects of chronic psychosocial stress on myocardial sensitivity to ischemic injury.

    Science.gov (United States)

    Rorabaugh, Boyd R; Krivenko, Anna; Eisenmann, Eric D; Bui, Albert D; Seeley, Sarah; Fry, Megan E; Lawson, Joseph D; Stoner, Lauren E; Johnson, Brandon L; Zoladz, Phillip R

    2015-01-01

    Individuals with post-traumatic stress disorder (PTSD) experience many debilitating symptoms, including intrusive memories, persistent anxiety and avoidance of trauma-related cues. PTSD also results in numerous physiological complications, including increased risk for cardiovascular disease (CVD). However, characterization of PTSD-induced cardiovascular alterations is lacking, especially in preclinical models of the disorder. Thus, we examined the impact of a psychosocial predator-based animal model of PTSD on myocardial sensitivity to ischemic injury. Male and female Sprague-Dawley rats were exposed to psychosocial stress or control conditions for 31 days. Stressed rats were given two cat exposures, separated by a period of 10 days, and were subjected to daily social instability throughout the paradigm. Control rats were handled daily for the duration of the experiment. Rats were tested on the elevated plus maze (EPM) on day 32, and hearts were isolated on day 33 and subjected to 20 min ischemia and 2 h reperfusion on a Langendorff isolated heart system. Stressed male and female rats gained less body weight relative to controls, but only stressed males exhibited increased anxiety on the EPM. Male, but not female, rats exposed to psychosocial stress exhibited significantly larger infarcts and attenuated post-ischemic recovery of contractile function compared to controls. Our data demonstrate that predator stress combined with daily social instability sex-dependently increases myocardial sensitivity to ischemic injury. Thus, this manipulation may be useful for studying potential mechanisms underlying cardiovascular alterations in PTSD, as well as sex differences in the cardiovascular stress response.

  2. EEG patterns from acute to chronic stroke phases in focal cerebral ischemic rats: correlations with functional recovery

    International Nuclear Information System (INIS)

    Monitoring the neural activities from the ischemic penumbra provides critical information on neurological recovery after stroke. The purpose of this study is to evaluate the temporal alterations of neural activities using electroencephalography (EEG) from the acute phase to the chronic phase, and to compare EEG with the degree of post-stroke motor function recovery in a rat model of focal ischemic stroke. Male Sprague–Dawley rats were subjected to 90 min transient middle cerebral artery occlusion surgery followed by reperfusion for seven days (n = 58). The EEG signals were recorded at the pre-stroke phase (0 h), acute phase (3, 6 h), subacute phase (12, 24, 48, 72 h) and chronic phase (96, 120, 144, 168 h) (n = 8). This study analyzed post-stroke seizures and polymorphic delta activities (PDAs) and calculated quantitative EEG parameters such as the alpha-to-delta ratio (ADR). The ADR represented the ratio between alpha power and delta power, which indicated how fast the EEG activities were. Forelimb and hindlimb motor functions were measured by De Ryck's test and the beam walking test, respectively. In the acute phase, delta power increased fourfold with the occurrence of PDAs, and the histological staining showed that the infarct was limited to the striatum and secondary sensory cortex. In the subacute phase, the alpha power reduced to 50% of the baseline, and the infarct progressed to the forelimb cortical region. ADRs reduced from 0.23 ± 0.09 to 0.04 ± 0.01 at 3 h in the acute phase and gradually recovered to 0.22 ± 0.08 at 168 h in the chronic phase. In the comparison of correlations between the EEG parameters and the limb motor function from the acute phase to the chronic phase, ADRs were found to have the highest correlation coefficients with the beam walking test (r = 0.9524, p < 0.05) and De Ryck's test (r = 0.8077, p < 0.05). This study measured EEG activities after focal cerebral ischemia and showed that functional recovery was closely

  3. Thoracic endovascular aortic repair for complicated chronic type B aortic dissection in a patient on hemodialysis with recurrent ischemic colitis.

    Science.gov (United States)

    Miyazaki, Yuko; Furuyama, Tadashi; Matsubara, Yutaka; Yoshiya, Keiji; Yoshiga, Ryosuke; Inoue, Kentaro; Matsuda, Daisuke; Aoyagi, Yukihiko; Kato, Masaaki; Matsumoto, Takuya; Maehara, Yoshihiko

    2016-12-01

    We present a successful case of thoracic endovascular aortic repair (TEVAR) for chronic Stanford type B aortic dissection (B-AD) with recurrent ischemic colitis. The patient was a 56-year-old woman with abdominal pain as the main complaint who had two operations previously: the total arch replacement 8 years ago and the Bentall 7 years ago for acute Stanford type A aortic dissection. Her abdominal pain worsened as her blood pressure became low during her hemodialysis treatment. An enhanced computed tomography scan was performed on the patient and showed chronic B-AD that occurred from the distal anastomotic part of the total arch graft to the bilateral common iliac arteries. The celiac artery and superior mesenteric artery (SMA) arose from the true lumen, and these were compressed by the expanded false lumen. Her complicated chronic B-AD was treated with the Zenith Dissection Endovascular System, and its procedure was performed as her proximal entry tear was covered by a proximal tapered Zenith TX2 stent graft, supplemented by a noncovered aortic stent extending across both renal arteries, the SMA, and the celiac artery. Seven days after this operation, enhanced computed tomography showed that the patient's true lumen was expanded and her blood flow to the true lumen and SMA was improved. On the other hand, her false lumen tended to be thrombosed. Consequently, she was discharged 10 days after the operation without any postoperative complications as she had no abdominal complaints even though she underwent hemodialysis three times per week after the operation. We believe that TEVAR supplemented by a noncovered aortic stent is an effective treatment, even for highly chronic B-AD in dialysis patients. PMID:27090121

  4. A Novel Closed-Chest Porcine Model of Chronic Ischemic Heart Failure Suitable for Experimental Research in Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Giuseppe Biondi-Zoccai

    2013-01-01

    Full Text Available Cardiac pathologies are among the leading causes of mortality and morbidity in industrialized countries, with myocardial infarction (MI representing one of the major conditions leading to heart failure (HF. Hitherto, the development of consistent, stable, and reproducible models of closed-chest MI in large animals, meeting the clinical realism of a patient with HF subsequent to chronic ischemic necrosis, has not been successful. We hereby report the design and ensuing application of a novel porcine experimental model of closed-chest chronic ischemia suitable for biomedical research, mimicking post-MI HF. We also emphasize the key procedural steps involved in replicating this unprecedented model, from femoral artery and vein catheterization to MI induction by permanent occlusion of the left anterior descending coronary artery through superselective deployment of platinum-nylon coils, as well as endomyocardial biopsy sampling for histologic analysis and cell harvesting. Our model could indeed represent a valuable contribution and tool for translational research, providing precious insights to understand and overcome the many hurdles concerning, and currently quenching, the preclinical steps mandatory for the clinical translation of new cardiovascular technologies for personalized HF treatments.

  5. Fibroblast growth factor-2 induced by enriched environment enhances angiogenesis and motor function in chronic hypoxic-ischemic brain injury.

    Directory of Open Access Journals (Sweden)

    Jung Hwa Seo

    Full Text Available This study aimed to investigate the effects of enriched environment (EE on promoting angiogenesis and neurobehavioral function in an animal model of chronic hypoxic-ischemic (HI brain injury. HI brain damage was induced in seven day-old CD-1® mice by unilateral carotid artery ligation and exposure to hypoxia (8% O2 for 90 min. At six weeks of age, the mice were randomly assigned to either EE or standard cages (SC for two months. Rotarod, forelimb-use asymmetry, and grip strength tests were performed to evaluate neurobehavioral function. In order to identify angiogenic growth factors regulated by EE, an array-based multiplex ELISA assay was used to measure the expression in frontal cortex, striatum, and cerebellum. Among the growth factors, the expression of fibroblast growth factor-2 (FGF-2 was confirmed using western blotting. Platelet endothelial cell adhesion molecule-1 (PECAM-1 and α-smooth muscle actin (α-SMA were also evaluated using immunohistochemistry. As a result, mice exposed to EE showed significant improvements in rotarod and ladder walking performances compared to SC controls. The level of FGF-2 was significantly higher in the frontal cortex of EE mice at 8 weeks after treatment in multiplex ELISA and western blot. On the other hand, FGF-2 in the striatum significantly increased at 2 weeks after exposure to EE earlier than in the frontal cortex. Expression of activin A was similarly upregulated as FGF-2 expression pattern. Particularly, all animals treated with FGF-2 neutralizing antibody abolished the beneficial effect of EE on motor performance relative to mice not given anti-FGF-2. Immunohistochemistry showed that densities of α-SMA(+ and PECAM-1(+ cells in frontal cortex, striatum, and hippocampus were significantly increased following EE, suggesting the histological findings exhibit a similar pattern to the upregulation of FGF-2 in the brain. In conclusion, EE enhances endogenous angiogenesis and neurobehavioral functions

  6. Noninvasive monitoring of cardiac function in a chronic ischemic heart failure model in the rat: Assessment with tissue Doppler and non-Doppler 2D strain echocardiography

    Directory of Open Access Journals (Sweden)

    Baumann Gert

    2011-05-01

    Full Text Available Abstract Objectives Feasibility of noninvasive monitoring of cardiac function after surgically induced ischemic cardiomyopathy with tissue Doppler and non-Doppler 2D strain echocardiography in rats. Background The optimal method for quantitative assessment of global and regional ventricular function in rats with chronic heart failure for research purposes remains unclear. Methods 20 rats underwent suture ligation of the left anterior descending coronary artery via a left thoracotomy to induce ischemic cardiomyopathy. Echocardiographic examination with estimation of left ventricular wall thickness, diameters, fractional shortening, ejection fraction, wall velocities as well as radial strain were performed before and 4 weeks after surgery. Results Mean LVEF decreased from 70 ± 6% to 40 ± 8% (p Conclusion It is feasible to assess dimensions, global function, and regional contractility with echocardiography in rats suffering from chronic heart failure after myocardial infarction. Particularly regional function can be exactly evaluated if tissue Doppler and 2D strain is used.

  7. Cytochrome P450 1B1 and 2C9 genotypes and risk of ischemic vascular disease, cancer, and chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Kaur-Knudsen, Diljit; Bojesen, Stig E; Nordestgaard, Børge G

    2012-01-01

    The aim of this review is to summarize present knowledge of genetic variation in cytochrome P450 1B1 (CYP1B1) and 2C9 (CYP2C9) genes and risk of tobacco-related cancer, female cancer, chronic obstructive pulmonary disease and ischemic vascular disease. The CYP1B1 and CYP2C9 enzymes metabolize...... between genetic variation in CYP1B1 and CYP2C9 and risk of disease with considerable statistical power rebutted the hypotheses that these genetic variants affect risk of tobacco-related cancer, female cancer, chronic obstructive pulmonary disease and ischemic vascular disease....... polycyclic aromatic hydrocarbons found in tobacco smoke and thereby generate disease-causing metabolites suggested to be important in tobacco-related diseases. Furthermore, CYP1B1 also metabolizes estrogen while CYP2C9 metabolizes arachidonic acid, both creating metabolites potentially important in risk...

  8. Arteritic anterior ischemic optic neuropathy associated with chronic myelomonocytic leukemia (CMML: A case report

    Directory of Open Access Journals (Sweden)

    Miriam García Fernández

    2015-02-01

    Full Text Available Introduction: Ocular involvement in patients with CMML is rarely reported, owing in part to the fact that the severe illness faced by many of these patients limits the feasibility of ocular examinations. Nevertheless, post-mortem examination of the eyes of patients without ophthalmological symptoms and diagnosis of CMML, has revealed ocular infiltration of atypical cells. Case report: A 72-year-old man presented with two days of left-sided blurring of vision and an episode of transient visual obscuration associated to periorbitary pain. A relative afferent pupillary defect was present in the LE. Fundus examination revealed optic disc swelling in LE. The erythrocyte sedimentation rate (ESR was 120 mm (1st hour and C-reactive protein was 7.8. Complementary examinations yielded normal findings. A presumptive diagnosis of arteritic anterior ischemic optic neuropathy (AAION was made. Treatment with endovenous bolus of methylprednisolone, followed by slow-tapering of oral steroids, was started, without improvement. Temporal artery biopsy confirmed the diagnosis. Conclusions: To our knowledge, this is the second case in peer-reviewed literature reporting the association between AAION and CMML. A possible explanation is the fact that small vessel vasculitis, of unclear pathogenesis so far, complicates approximately 10% of CMML and presents as cutaneous vasculitis and lupus-like syndromes. Therefore, this may be in relation with the vasculitis of the short posterior ciliary arteries which happens in cases of AAION.

  9. DETERMINANTS OF PREVENTIVE BEHAVIOR REGARDING CARDIOVASCULAR DISEASES AND RISK FACTORS IN PATIENTS WITH ESSENTIAL HYPERTENSION AND CHRONIC ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    D. Yu. Platonov

    2011-01-01

    Full Text Available Aim. To analyze potential determinants of preventive behavior (PB in patients with essential hypertension (HT and chronic ischemic heart disease (CIHD, and to establish their significance and hierarchy. Material and methods. Patients with HT (n=285 and CIHD (n=223 were studied. Questioning of all patients was performed to assess the characteristics of their PB. Differentiated multivariate analysis of activity and efficacy of PB determinants was performed in HT and CIHD patients by the method of step-by-step backward logistic regression. Results. Awareness of the cardiovascular diseases (CVD and its prevention (odds ratio [OR] 6.08 as well as high level of general education (OR=2.29 were the most significant determinants of active PB in HT patients. Sufficient social support (OR=3.77, awareness of CVD and its prevention (OR=3.16 were the most significant determinants of active PB in patients with CIHD. Efficacy of PB in patients with HT and CIHD mostly depends on satisfaction of medical service (OR=10.2 and 6.63, respectively, social support (OR=6.25 and 10.5, respectively, adequate awareness of CVD and its prevention (OR, 6.92 and 6.64, respectively. Conclusion. PB activity and efficacy in patients with HT and CIHD depends on many contributing and impeding factors. Disregarding these factors can result in failure in preventive efforts at both individual and population levels.

  10. Quantification of late gadolinium enhanced CMR in viability assessment in chronic ischemic heart disease: a comparison to functional outcome

    Directory of Open Access Journals (Sweden)

    Afsharzada Farshid

    2009-03-01

    Full Text Available Abstract Background Quantification of late gadolinium enhanced cardiovascular magnetic resonance (LGE CMR by objective window setting increases reproducibility and facilitates multicenter comparison and cooperation. So far, quantification methods or models have only been validated to postmortem animal studies. This study was undertaken to evaluate quantification of LGE in relation to the clinical standard of viability, i.e. functional outcome after revascularization. Thirty-eight patients with chronic ischemic myocardial dysfunction underwent cine and LGE 1 month before and cine CMR 6 months after coronary revascularization. Enhancement was quantified by thresholding window setting at: 2-8SD above mean signal intensity of a remote normal region, and according to the full width at half maximum method (FWHM. Dysfunctional segments were divided in 5 groups according to segmental extent of enhancement (SEE: SEE 1 – no enhancement to SEE 5 – 76–100% with each quantification method. Results Quantification methods had a strong influence on SEE and total infarct size. Multilevel analysis showed that thresholding contrast images at 6SD best predicted segmental functional outcome after revascularization, but the difference with other methods was small and non-significant. Conclusion Simple thresholding techniques strongly influence global and segmental extent of LGE, but have relatively little influence on the accuracy to predict segmental functional improvement after revascularization.

  11. Longitudinal rotating frame relaxation time measurements in infarcted mouse myocardium in vivo.

    Science.gov (United States)

    Musthafa, Haja-Sherief N; Dragneva, Galina; Lottonen, Line; Merentie, Mari; Petrov, Lyubomir; Heikura, Tommi; Ylä-Herttuala, Elias; Ylä-Herttuala, Seppo; Gröhn, Olli; Liimatainen, Timo

    2013-05-01

    Longitudinal relaxation time in the rotating frame (T1ρ) was measured using continuous wave irradiation in normal and infarcted mouse myocardium in vivo. Significant increase in T1ρ was found after 7 days of infarction when compared with reference myocardium or in myocardium before infarction. Cine MRI and histology were performed to verify the severity of infarction. The time course of T1ρ in the infarct fits better with granulation and scar tissue formation than necrosis and edema. The results of the study show that T1ρ could potentially be a noninvasive quantitative marker for tissue remodeling after ischemic damage. PMID:22736543

  12. Vitamin D deficiency aggravates chronic kidney disease progression after ischemic acute kidney injury.

    Directory of Open Access Journals (Sweden)

    Janaína Garcia Gonçalves

    Full Text Available Despite a significant improvement in the management of chronic kidney disease (CKD, its incidence and prevalence has been increasing over the years. Progressive renal fibrosis is present in CKD and involves the participation of several cytokines, including Transforming growth factor-β1 (TGF-β1. Besides cardiovascular diseases and infections, several studies show that Vitamin D status has been considered as a non-traditional risk factor for the progression of CKD. Given the importance of vitamin D in the maintenance of essential physiological functions, we studied the events involved in the chronic kidney disease progression in rats submitted to ischemia/reperfusion injury under vitamin D deficiency (VDD.Rats were randomized into four groups: Control; VDD; ischemia/reperfusion injury (IRI; and VDD+IRI. At the 62 day after sham or IRI surgery, we measured inulin clearance, biochemical variables and hemodynamic parameters. In kidney tissue, we performed immunoblotting to quantify expression of Klotho, TGF-β, and vitamin D receptor (VDR; gene expression to evaluate renin, angiotensinogen, and angiotensin-converting enzyme; and immunohistochemical staining for ED1 (macrophages, type IV collagen, fibronectin, vimentin, and α-smooth mucle actin. Histomorphometric studies were performed to evaluate fractional interstitial area.IRI animals presented renal hypertrophy, increased levels of mean blood pressure and plasma PTH. Furthermore, expansion of the interstitial area, increased infiltration of ED1 cells, increased expression of collagen IV, fibronectin, vimentin and α-actin, and reduced expression of Klotho protein were observed. VDD deficiency contributed to increased levels of plasma PTH as well as for important chronic tubulointerstitial changes (fibrosis, inflammatory infiltration, tubular dilation and atrophy, increased expression of TGF-β1 and decreased expression of VDR and Klotho protein observed in VDD+IRI animals.Through inflammatory

  13. Stromal Vascular Fraction Transplantation as an Alternative Therapy for Ischemic Heart Failure: Anti-inflammatory Role

    Directory of Open Access Journals (Sweden)

    Lin Xue

    2011-03-01

    Full Text Available Abstract Background The aims of this study were: (1 to show the feasibility of using adipose-derived stromal vascular fraction (SVF as an alternative to bone marrow mono nuclear cell (BM-MNC for cell transplantation into chronic ischemic myocardium; and (2 to explore underlying mechanisms with focus on anti-inflammation role of engrafted SVF and BM-MNC post chronic myocardial infarction (MI against left ventricular (LV remodelling and cardiac dysfunction. Methods Four weeks after left anterior descending coronary artery ligation, 32 Male Lewis rats with moderate MI were divided into 3 groups. SVF group (n = 12 had SVF cell transplantation (6 × 106 cells. BM-MNC group (n = 12 received BM-MNCs (6 × 106 and the control (n = 10 had culture medium. At 4 weeks, after the final echocardiography, histological sections were stained with Styrus red and immunohistochemical staining was performed for α-smooth muscle actin, von Willebrand factor, CD3, CD8 and CD20. Results At 4 weeks, in SVF and BM-MNC groups, LV diastolic dimension and LV systolic dimension were smaller and fractional shortening was increased in echocardiography, compared to control group. Histology revealed highest vascular density, CD3+ and CD20+ cells in SVF transplanted group. SVF transplantation decreased myocardial mRNA expression of inflammatory cytokines TNF-α, IL-6, MMP-1, TIMP-1 and inhibited collagen deposition. Conclusions Transplantation of adipose derived SVF cells might be a useful therapeutic option for angiogenesis in chronic ischemic heart disease. Anti-inflammation role for SVF and BM transplantation might partly benefit for the cardioprotective effect for chronic ischemic myocardium.

  14. Functional versus Nonfunctional Rehabilitation in Chronic Ischemic Stroke: Evidences from a Randomized Functional MRI Study

    Directory of Open Access Journals (Sweden)

    Maristela C. X. Pelicioni

    2016-01-01

    Full Text Available Motor rehabilitation of stroke survivors may include functional and/or nonfunctional strategy. The present study aimed to compare the effect of these two rehabilitation strategies by means of clinical scales and functional Magnetic Resonance Imaging (fMRI. Twelve hemiparetic chronic stroke patients were selected. Patients were randomly assigned a nonfunctional (NFS or functional (FS rehabilitation scheme. Clinical scales (Fugl-Meyer, ARA test, and modified Barthel and fMRI were applied at four moments: before rehabilitation (P1 and immediately after (P2, 1 month after (P3, and three months after (P4 the end of rehabilitation. The NFS group improved significantly and exclusively their Fugl-Meyer scores at P2, P3, and P4, when compared to P1. On the other hand, the FS group increased significantly in Fugl-Meyer at P2, when compared to P1, and also in their ARA and Barthel scores. fMRI inspection at the individual level revealed that both rehabilitation schemes most often led to decreased activation sparseness, decreased activity of contralesional M1, increased asymmetry of M1 activity to the ipsilesional side, decreased perilesional activity, and decreased SMA activity. Increased M1 asymmetry with rehabilitation was also confirmed by Lateralization Indexes. Our clinical analysis revealed subtle differences between FS and NFS.

  15. Treatment of chronical myocardial ischemia by adenovirus-mediated hypatocyte growth factor gene transfer in minipigs

    Institute of Scientific and Technical Information of China (English)

    YUAN Biao; ZHANG YouRong; ZHAO Zhong; WU DanLi; YUAN LiZhen; WU Bin; WANG LiSheng; HUANG Jun

    2008-01-01

    Growth factor gene transfer-induced therapeutic angiogenesis has become a novel approach for the treatment of myocardial ischemia. In order to provide a basis for the clinical application of an adeno-virus with hepatocyte growth factor gene (Ad-HGF) in the treatment of myocardial ischemia, we estab-lished a minipig model of chronically ischemic myocardium in which an Ameroid constrictor was placed around the left circumflex branch of the coronary artery (LCX). A total of 18 minipigs were ran-domly divided into 3 groups: a surgery control group, a model group and an Ad-HGF treatment group implanted with Ameroid constrictor. Ad-HGF or the control agent was injected directly into the ischemic myocardium, and an improvement in heart function and blood supply were evaluated. The results showed that myocardial perfusion remarkably improved in the Ad-HGF group compared with that in both the control and model groups. Four weeks after the treatment, the density of newly formed blood vessels was higher and the number of collateral blood vessels was greater in the Ad-HGF group than in the model group. The area of myocardial ischemia reduced evidently and the left ventricular ejection fraction improved significantly in the Ad-HGF group. These results suggest that HGF gene therapy may become a novel approach in the treatment of chronically ischemic myocardium.

  16. Treatment of chronical myocardial ischemia by adenovirus-mediated hepatocyte growth factor gene transfer in minipigs

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Growth factor gene transfer-induced therapeutic angiogenesis has become a novel approach for the treatment of myocardial ischemia. In order to provide a basis for the clinical application of an adeno- virus with hepatocyte growth factor gene (Ad-HGF) in the treatment of myocardial ischemia, we estab- lished a minipig model of chronically ischemic myocardium in which an Ameroid constrictor was placed around the left circumflex branch of the coronary artery (LCX). A total of 18 minipigs were ran- domly divided into 3 groups: a surgery control group, a model group and an Ad-HGF treatment group implanted with Ameroid constrictor. Ad-HGF or the control agent was injected directly into the ischemic myocardium, and an improvement in heart function and blood supply were evaluated. The results showed that myocardial perfusion remarkably improved in the Ad-HGF group compared with that in both the control and model groups. Four weeks after the treatment, the density of newly formed blood vessels was higher and the number of collateral blood vessels was greater in the Ad-HGF group than in the model group. The area of myocardial ischemia reduced evidently and the left ventricular ejection fraction improved significantly in the Ad-HGF group. These results suggest that HGF gene therapy may become a novel approach in the treatment of chronically ischemic myocardium.

  17. Effect of ischemic preconditioning on HIF-1α and HO-1 in myocardium after myocardial ischemia-reperfusion injury in rats%缺血预处理对大鼠缺血再灌注心肌HIF-1α和HO-1的影响

    Institute of Scientific and Technical Information of China (English)

    何祥虎; 王焱林; 王成天; 张宗泽; 饶艳; 颜学滔; 李卉

    2010-01-01

    Objective To investigate the effect of ischemic preconditioning(IP)on hypoxia inducible factor-1α(HIF-1α)and heme oxygenase-1(HO-1)in myocardium after myocardial ischemia-reperfusian(I/R)injury in rata and the mechanism.Methods Forty-eight male SD rata weighing 220-280 g were randomly divided into 4 groups(n= 12 each): group A sham operation;group B I/R;group C IP+I/R and group DIP+IR+HO-1 inhibitor.The animals were anesthetized with intraperitoneal 20% urethane 1 g/kg,tracheoatomized and mechanically ventilated.Myocardial ischemia was induced by 30 min occlusion of left anterior descending branch(LAD)of coronary artery followed by 120 min reperfusion,Ischemic preconditioning was induced by 3 episodes of5 min occlusion of LAD at 5 min intervals before myocardial ischemia.Group D received HO-1 inhibitor ZnPP Ⅸ10 mg/kg one day before IP.At the end of 120 min reperfusion the infarct size was measured,the expression of HIF-1α and HO-1 mRNA and protein,SOD and HO-1 activities and MDA content in myocardium and serum TNF-αand IL-6 concentrations were determined.Results Compared with sham operation group,I/R significantly increased MDA content in myocardium and serum TNF-α and IL-6 concentrations and decreased SOD activity in myocardium.Compared with I/R group,IP significantly decreased infarct size,increased HIF-1α and HO-1 mRNA and protein expression and HO-1 activity further and decreased serum TNF-α and IL-6 concentrations and myocardial MDA content in group C.In group D ZnPP Ⅸ pretreatment greatly increased infarct size which was significantly larger than that in group I/R and group IP+I/R.Conclusion IP can protect against myocardial I/R injury.Increase in HO-1 activity induced by HIP-1α may be involved in the underlying mechanism.%目的 探讨缺血预处理对大鼠缺血再灌注心肌低氧诱导因子1α(HIF-1α)和血红素加氧酶1(HO-1)的影响.方法 健康雄性SD大鼠48只,体重220~280 g,随机分为4组(n=12):假手术组(S组)、缺血

  18. Effect of autologous bone marrow stem cells mobilization at different time points on vascular regeneration of acute ischemic myocardium%不同时间自体骨髓动员急性缺血心肌的血管再生

    Institute of Scientific and Technical Information of China (English)

    虞桂平; 沈振亚; 余云生; 郭世强; 陈一欢; 胡雁秋

    2012-01-01

    with granulocyte colony-stimulating factor (G-CSF) at the 3rd hour after modeling and last for 5 days; 1 week mobilization group, injected with G-CSF at the 1st week after modeling and last for 5 days.RESULTS AND CONCLUSION: Compared with control group, the functional parameter, such as ejection fraction, left ventricular internal dimension diastole and left ventricular internal dimension systole in immediate mobilization group and 1 week mobilization group were improved significantly. And after bone marrow mobilization, the serum levels of vascular endothelial growth factor (VEGF) in the two groups were significantly elevated, as well as the vascular density. There was no obvious difference in control group. Bone marrow stem cells were mobilized by G-CSF and migrated to the site of myocardial infarction, and differentiated into initial vascular structure, and take part in the vascular formation in ischemic myocardium.

  19. Ischemic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually ... are at risk for having a more serious stroke. Symptoms of stroke are Sudden numbness or weakness ...

  20. Ischemic Stroke

    Science.gov (United States)

    ... can help you. Learn more What Is Stroke? Hemorrhagic Stroke Ischemic Stroke What is TIA? Stroke Facts Recognizing ... Stroke Survey Faces of Stroke What is stroke? Hemorrhagic stroke Ischemic stroke What is TIA? Stroke facts I ...

  1. STUDY ON LIQUID-LIQUID EXTRACTION OF RESVERATROL FROM GIANT KNOTWEED AND ITS PROTECTIVE EFFECT ON MYOCARDIUM INJURY

    Institute of Scientific and Technical Information of China (English)

    唐玉海; 刘芸; 黄伟; 刘宏浪

    2002-01-01

    Objective An efficient extraction and separation method of resveratrol from a Chinese herb giant knotweed was developed and the protective effect of resveratrol on myocardium injury was investigated.Methods An orthogonal experiment was utilized to optimize the extraction conditions and the pure white crystal obtained utilizing the proposed method was used for the investigation of myocardium ischemic injury.Results Resveratrol was found to have many beneficial activities including the protective effect on the heart and the scavenging of free radical.Conclusion The protective effect of resveratrol on myocardium injury is related to the quenching of lipid peroxidation.

  2. Detection of viable myocardium using coronary angiography and ventriculography.

    Science.gov (United States)

    Conti, C Richard

    2002-08-01

    In 2002, coronary angiography is the only way to assess precisely the combination of proximal stenoses, distal target vessels, collaterals, microcirculation, and TIMI antegrade flow. At the time of coronary angiography, global LV function is best determined using biplane ventriculography in order to correlate wall motion with coronary stenoses, distal target vessels, microcirculation, collaterals, and antegrade TIMI flow. This can be done under resting conditions after nitrates or after postextrasystolic potentiation. The absolute diagnosis of viability can only be made retrospectively. Large areas of ischemic viable myocardium should improve contraction after revascularization, decrease symptoms, and prolong survival.

  3. Direct effects of smoking on the heart: silent ischemic disturbances of coronary flow

    International Nuclear Information System (INIS)

    Cigarette smoking is strongly associated with ischemic heart disease and acute coronary events. The effect of smoking a single cigarette on regional myocardial perfusion was studied in 13 chronic smokers with typical stable angina pectoris using positron emission tomography and rubidium-82 (82Rb). Findings were compared with the effects of physical exercise. After exercise, 8 patients (61%) had angina, ST depression and abnormal regional myocardial perfusion. Uptake of 82Rb increased from 49 +/- 8 to 60 +/- 7 in remote myocardium, but decreased from 46 +/- 3 to 37 +/- 5 in an ischemic area. The remaining 5 patients (39%) had homogeneous increases in 82Rb uptake without angina or ST depression. After smoking, 6 of the 8 patients with positive exercise test responses had a decrease in 82Rb uptake, from 47 +/- 3 to 35 +/- 6 in the same segment of myocardium affected during exercise. However, in contrast to exercise, the events during smoking were largely silent. The absolute decreases in regional 82Rb uptake after smoking occurred at significantly lower levels of myocardial oxygen demand than after exercise. This suggests that an impairment of coronary blood supply is responsible. Thus, in smokers with coronary artery disease, each cigarette can cause profound silent disturbances of regional myocardial perfusion that are likely to occur frequently during daily life. Such repeated insults may represent an important mechanism linking smoking with coronary events

  4. Ultra-structure compare of normal left ventricle with chronic heart failure myocardium%慢性心力衰竭与正常左心室心肌组织超微结构的比较

    Institute of Scientific and Technical Information of China (English)

    张海波; 赖斯颖; 孟旭; 王世强; 韩杰; 李岩; 贾一新

    2011-01-01

    Objective: To observe the chronic heart faiure ( CHF) left ventricular myocardial ultrastructural changes, and investigate the structural basis of chronic heart failure. Methods : Left ventricular tissue samples from patients received heart transplantation with heart failure, and healthy donors were examined by transmission electron micmscope to compare their ultra-structure difference. And the horizontal tube and mitochondrial morphology indicators were measured. Results : Compared with normal left ventricular myocardium ultra-thin sections, left ventricle samples from the patients with heart railure showed myofilament dislocation and disorder, horizontal tube perimeter and area increased and the density decreased , mitochondrial area decreased ,the circular degree of increased, large amounts of glycogen accumulation in the mitochondria and the surrounding filaments. Conclusion : Left ventricular myocardial ultrastructure changes of the heart failure samples is the construction base of the contractile efficiency decline and the energy supply obstacles.%目的:观察慢性心力衰竭(心衰)时左心室心肌组织超微结构的改变,探讨慢性心衰的结构基础.方法:收集心衰末期心脏移植患者及健康捐赠者的左心室心肌组织样品,通过透射电子显微镜,比较它们的超微结构,并测量其横管及线粒体的形态指标.结果:与正常左心室心肌组织的超薄切片比较,心衰患者左心室心肌组织中肌丝排列发生错位和紊乱,横管周长及面积增大、密度减少,线粒体面积减少、圆形度增加,多量糖原聚集在线粒体和肌丝周围.结论:慢性心衰时左心室心肌超微结构的这些改变是心肌细胞的收缩效能下降及能量供应障碍的结构基础.

  5. Measurement of the healing ability of ischemic ulcers in the lower limbs in chronic arterial obstructive disease using 201Tl-Cl

    International Nuclear Information System (INIS)

    Evaluation of the healing ability of ischemic ulcers by a method involving measurement of the ulcer index (U. I.) and mean ulcer index of toes (mU. I.) using 201Tl-Cl before and after the treatment of chronic arterial obstructive disease accompanied by ischemic ulcer was studied. The lesions consisted of 56 ulcers in 41 limbs. Reactive hyperemia following avascularization stress was used for measurement, and U. I. was determined according to the method of Siegel et al. For cases with toe ulcers, the mU. I. was measured from plantar scintigrams, twice under stress and upon redistribution after 3 hours' rest. The following results were obtained. 1) The healing ability of the cases with a U. I. value of more than 1.4 was good, but even among cases with a pretreatment U. I. of 0.9 - 1.4, ulcer healing was also good in cases in which the U. I. was maintained above 1.4 as a result of various treatments. 2) Significant increases in U. I. were observed in the arterial reconstruction group after treatment, compared to the conservative treatment group and the lumbar sympathectomy group. 3) The healing ability was good in cases with an mU. I. of more than 1.2 at stress except for 2 ASO cases complicated by diabetes. 4) Although it was difficult to prognosticate the healing ability of cases with an mU. I. of less than 1.2 before treatment, healing ability could be evaluated after treatment on the basis of the appearance of significant increase in blood flow on stress in the ulcerated toes. 5) A stress index seemed to reflect the ischemic conditions in ulcerated toes in relation to stress. 6) U. I. and mU. I. measured using 201Tl-Cl were significantly correlated with the degree of inflammatory and reactive hyperemia in the floor of ulcers and in the ulcerated toes. (J.P.N.)

  6. A Common Polymorphism of the Human Cardiac Sodium Channel Alpha Subunit (SCN5A Gene Is Associated with Sudden Cardiac Death in Chronic Ischemic Heart Disease.

    Directory of Open Access Journals (Sweden)

    Boglárka Marcsa

    Full Text Available Cardiac death remains one of the leading causes of mortality worldwide. Recent research has shed light on pathophysiological mechanisms underlying cardiac death, and several genetic variants in novel candidate genes have been identified as risk factors. However, the vast majority of studies performed so far investigated genetic associations with specific forms of cardiac death only (sudden, arrhythmogenic, ischemic etc.. The aim of the present investigation was to find a genetic marker that can be used as a general, powerful predictor of cardiac death risk. To this end, a case-control association study was performed on a heterogeneous cohort of cardiac death victims (n=360 and age-matched controls (n=300. Five single nucleotide polymorphisms (SNPs from five candidate genes (beta2 adrenergic receptor, nitric oxide synthase 1 adaptor protein, ryanodine receptor 2, sodium channel type V alpha subunit and transforming growth factor-beta receptor 2 that had previously been shown to associate with certain forms of cardiac death were genotyped using sequence-specific real-time PCR probes. Logistic regression analysis revealed that the CC genotype of the rs11720524 polymorphism in the SCN5A gene encoding a subunit of the cardiac voltage-gated sodium channel occurred more frequently in the highly heterogeneous cardiac death cohort compared to the control population (p=0.019, odds ratio: 1.351. A detailed subgroup analysis uncovered that this effect was due to an association of this variant with cardiac death in chronic ischemic heart disease (p=0.012, odds ratio = 1.455. None of the other investigated polymorphisms showed association with cardiac death in this context. In conclusion, our results shed light on the role of this non-coding polymorphism in cardiac death in ischemic cardiomyopathy. Functional studies are needed to explore the pathophysiological background of this association.

  7. Reverse left ventricular remodeling is more likely in non ischemic cardiomyopathy patients upgraded to biventricular stimulation after chronic right ventricular pacing

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    Morales Maria-Aurora

    2011-12-01

    Full Text Available Abstract Background Chronic right ventricular (RV apical pacing may lead to left ventricular (LV dyssynchrony and LV dysfunction. In heart failure due to RV pacing, upgrading to biventricular stimulation (CRT can improve NYHA Class and LV function. A proportion of patients do not respond to upgrading. Aim was to assess whether etiology of LV dysfunction accounts for responses to CRT in RV-paced patients. Methods Sixty-two patients treated by CRT, under RV pacing from 50.2 ± 5.4 months, were studied. Cause of LV dysfunction was non-ischemic (NIC in 28 and ischemic cardiomyopathy (IC in 34 patients. Clinical and conventional echocardiographic parameters were available within 1 month before RV pacing, within 1 month before CRT and at 12 ± 2 months of follow-up (FU. Results Decreased LVEF (from 37.0 ± 8.8 to 25.6 ± 6.1%, p 10% decrease in LVESD was observed in 24 patients: 5 with IC, 19 with NIC (p 10% decrease in LVESD remained highly significant (p Conclusions CRT improves functional class even after long-lasting pacing. Reverse remodeling is evident in a small population, more likely with NIC.

  8. 缺血预处理对糖尿病大鼠在体心肌NO-cGMP表达的影响%Changes in nitric oxide level and guanosine monophosphate activity after ischemic preconditioning in diabetes myocardium: in vivo rat hearts

    Institute of Scientific and Technical Information of China (English)

    韩宏光; 韩劲松; 王辉山; 张南滨; 姜辉; 尹宗涛

    2011-01-01

    reperfusion.Ischemia/reperfusion group( I/R group,n =10),after surgery,the rats were balanced for 35 minutes and then subjected to 30 minutes of ischemia followed by 90 minutes of reperfusion.At the end of the experiment,the hearts of each group were excided quickly,frozen in liquid nitrogen and stored at 80 ℃ until membrane and cytoplasm preparation.The changes of activities of the serum creatine kinase (CK),creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) were detected.The activity of malonyldialdehyde (MDA),superoxide dismutase (SOD) in myocardium were dectected were assessed.In addition,the changes of content of myocardial cGMP and NO were assessed.Ultrathin sections 70 nm thick was made and transmission electron microscopy was used to detect the structure of the mitochondria with the Flameng scoring system.Results Myocardial enzyme leakage and mitochondria injury were significantly reduced compared IPC group and I/R group in non-diabetic rats,and cGMP,NO and NOS were also significantly increased (P <0.05 ).There did not show significant myocardial protective effect in diabetic rats,cGMP.NO and NOS showed also no significant increase in diabetic rats ( P > 0.05 ).Conclusion Diabetes inhibited the protective effect of ischemic preconditioning on ischemic reperfused rat heart,which may be related with inhibiting of the expression of the NO-cGMP signaling pathway.

  9. Myocardial energy metabolism in ischemic preconditioning, role of adenosine catabolism

    OpenAIRE

    Kavianipour, Mohammad

    2002-01-01

    Brief episodes of ischemia and reperfusion render the myocardium more resistant to necrosis from a subsequent, otherwise lethal ischemic insult. This phenomenon is called ischemic preconditioning(IP). Today, much is known about the signalling pathways involved in IP; however, the details of the final steps leading to cardioprotection, remain elusive. Adenosine (a catabolite of ATP) plays a major role in the signalling pathways of IP. Following IP there is an unexplained discrepancy between an...

  10. Electrophysiologic Effects of Propafenone on Ischemic Ventricular Tachyarrhythmias

    Institute of Scientific and Technical Information of China (English)

    Liu Musheng; Ma Yanfeng; Guo Zhibin

    2006-01-01

    Objectives To observe the electrophysiologic effects of propafenone (Prop) on ischemic ventricular tachyarrhythmias. Methods A canine ischemic ventricular tachyarrhythmia model was established in open-chest dogs subjected to programmed electrical stimulation (PES) on 5~8 days after acute myocardial infarction. The electrophysiologic effects of propafenone were observed in the model. Results Propafenone distinctly lengthened the QTc interval (P> 0.01) and effective refractory period (ERP) of normal and ischemic ventricular myocardium (NERP and IERP) respectively (P > 0.01), decreased the dispersion of ERP in ischemic myocardium and in left ventricle (P > 0.01), and increased the diastolic excitability threshold of normal and ischemic ventricular myocardium remarkably (P > 0.01). Propafenone effectively prevented PES-induced ventricular tachycardia (VT) or ventricular fibrillation (VF)(P > 0.01) and ischemia-induced VT/VF (P > 0.05).Conclusions The results indicated that the canine model produced by our methods is a worthy and reliable one, propafenone may be effective in preventing the onset of VT/VF after myocardial ischemic damage in dogs, and deserve further attention as an antifibrillatory agent.

  11. Capillary transfer constant of Gd-DTPA in the myocardium at rest and during vasodilation assessed by MRI

    DEFF Research Database (Denmark)

    Fritz-Hansen, T; Rostrup, Egill; Søndergaard, Lise;

    1998-01-01

    The purpose of this study was to determine whether the capillary transfer constant (Ki) of gadolinium-DTPA was sensitive to perfusion changes and whether ischemic regions in the myocardium could be identified using the modified Kety formula. Ki was measured at rest and during dipyridamole-induced...

  12. Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Eleni Dokoutsidou

    2009-05-01

    Full Text Available Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etiology, can be classified into two major categories, ischemic and hemorrhagic. 20% of stroke are of hemorrhagic type, whereas 80% are of ischemic type. Although, ischemic stroke is the most common type, its’ etiology differs. Ischemic stroke is categorized in thrombotic, embolic, lacunar, unknown etiology, transient and due to systematic low blood pressure. In the literature is cited that risk factors for stroke are classified in non-modifiable and modifiable. Non-modifiable risk factors are age, gender, ethnicity and heredity. The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes mellitus, cigarette smoking (active and passive, carotid artery stenosis, heavy alcohol consumption, drug abuse, lack of physical activity, obesity and unhealthy diet.Conclusions: As it is supported by published evidence, ischemic stroke is of higher incidence compared to hemorrhagic stroke. Risk factor modification remains as the principal aspect of care for ischemic stroke prevention.

  13. Diabetes and ischemic heart disease

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Holmager, Pernille;

    2014-01-01

    The aim of this study was to test i) whether patients having diabetes and ischemic heart disease (IHD), i.e., patients suffering from two chronic diseases, demonstrate a higher degree of chronic stress when compared with patients suffering from IHD alone, and ii) whether suffering from the two...

  14. 二维斑点追踪成像评价新生猪缺氧缺血性脑病模型受损心肌圆周运动%Assessing Circumferential Motion of Damaged Myocardium in Newborn Pigs with Hypoxic-ischemic Encephalopathy Using Speckle Tracking Imaging

    Institute of Scientific and Technical Information of China (English)

    乔伟; 任卫东; 肖杨杰; 毕文静; 李红; 王晓明

    2013-01-01

      目的应用二维斑点追踪成像(STI)评价新生猪缺氧缺血性脑病(HIE)模型损伤心肌圆周运动,观察其病理变化。材料与方法18只新生约克猪随机抽签分为对照组(n=8)和模型组(n=10),模型组行气管插管、低氧通气及双颈动脉夹闭,对照组假手术、不予低氧及夹闭。造模24 h测量整体、基底、中间、心尖水平圆周应变及圆周应变率(SrC)峰值,包括圆周应变峰值(SC)、收缩期圆周应变率峰值(SrC S)、舒张早期圆周应变率峰值(SrC E)、舒张晚期圆周应变率峰值(SrC A),测量心率(HR)、左心室射血分数(LVEF)及Tei指数。对脑及心肌组织行病理检查。结果模型组新生猪造模后相继出现发绀、抽搐、颈强直等改变,对照组无明显行为异常,两组新生猪均无死亡。对照组脑神经元细胞完整、清晰,模型组脑神经元细胞变性、坏死,造模成功。与对照组比较,模型组各水平SC、SrC S、SrC E、SrC A均减低,HR加快,LVEF下降,Tei指数升高,差异均有统计学意义(P<0.05)。模型组心肌细胞发生变性、坏死及凋亡,对照组心肌细胞整齐、清晰。结论模型早期心肌圆周运动减低,心功能下降,心肌细胞出现变性、坏死及凋亡,心肌圆周应变及应变率检测可早期评价新生猪HIE合并心肌损伤,为研究新生儿HIE合并心肌损伤提供了动物实验基础。%Purpose To evaluate the changes of circumferential motion using speckle tracking imaging (STI), and correlate with pathology of the damaged myocardium of newborn pigs with hypoxic-ischemic encephalopathy (HIE). Materials and Methods Eighteen newborn pigs were randomly divided into control group (n=8) and experimental group (n=10). The bilateral carotid arteries were blocked and 6% oxygen given mechanically in the experimental group. Sham operation was performed in the control group

  15. Ischemic Segment Detection using the Support Vector Domain Description

    DEFF Research Database (Denmark)

    Hansen, Michael Sass; Ólafsdóttir, Hildur; Sjöstrand, Karl;

    2007-01-01

    and registration of the myocardium provided pixel-wise signal intensity curves that were analyzed using the Support Vector Domain Description (SVDD). In contrast to normal SVDD, the entire regularization path was calculated and used to calculate a generalized distance. The results corresponded well to the ischemic...

  16. Particulate air pollution and chronic ischemic heart disease in the eastern United States: a county level ecological study using satellite aerosol data

    Directory of Open Access Journals (Sweden)

    Rao K Ranga

    2009-06-01

    Full Text Available Abstract Background There are several known factors that cause ischemic heart disease. However, the part played by air pollution still remains something of a mystery. Recent attention has focused on the chronic effect of particulate matter on heart disease. Satellite-derived aerosol optical depth (AOD was found to be correlated with PM2.5 in the eastern US. The objective of this study was to examine if there is an association between aerosol air pollution as indicated by AOD and chronic ischemic heart disease (CIHD in the eastern US. Methods An ecological geographic study method was employed. Race and age standardized mortality rate (SMR of CIHD was computed for each of the 2306 counties for the time period 2003–2004. A mean AOD raster grid for the same period was derived from Moderate Resolution Imaging Spectrometer (MODIS aerosol data and the average AOD was calculated for each county. A bivariate Moran's I scatter plot, a map of local indicator of spatial association (LISA clusters, and three regression models (ordinary least square, spatial lag, and spatial error were used to analyze the relationship between AOD and CIHD SMR. Results The global Moran's I value is 0.2673 (p = 0.001, indicating an overall positive spatial correlation of CIHD SMR and AOD. The entire study area is dominated by spatial clusters of AOD against SMR (high AOD and high SMR in the east, and low AOD and low SMR in the west (permutations = 999, p = 0.05. Of the three regression models, the spatial error model achieved the best fit (R2 = 0.28. The effect of AOD is positive and significant (beta = 0.7774, p = 0.01. Conclusion Aerosol particle pollution has adverse effect on CIHD mortality risk in the eastern US. High risk of CIHD mortality was found in areas with elevated levels of outdoor aerosol air pollution as indicated by satellite derived AOD. The evidence of the association would support targeting of policy interventions on such areas to reduce air pollution

  17. Global intracoronary infusion of allogeneic cardiosphere-derived cells improves ventricular function and stimulates endogenous myocyte regeneration throughout the heart in swine with hibernating myocardium.

    Directory of Open Access Journals (Sweden)

    Gen Suzuki

    Full Text Available Cardiosphere-derived cells (CDCs improve ventricular function and reduce fibrotic volume when administered via an infarct-related artery using the "stop-flow" technique. Unfortunately, myocyte loss and dysfunction occur globally in many patients with ischemic and non-ischemic cardiomyopathy, necessitating an approach to distribute CDCs throughout the entire heart. We therefore determined whether global intracoronary infusion of CDCs under continuous flow improves contractile function and stimulates new myocyte formation.Swine with hibernating myocardium from a chronic LAD occlusion were studied 3-months after instrumentation (n = 25. CDCs isolated from myocardial biopsies were infused into each major coronary artery (∼ 33 × 10(6 icCDCs. Global icCDC infusion was safe and while ∼ 3% of injected CDCs were retained, they did not affect ventricular function or myocyte proliferation in normal animals. In contrast, four-weeks after icCDCs were administered to animals with hibernating myocardium, %LADWT increased from 23 ± 6 to 51 ± 5% (p<0.01. In diseased hearts, myocyte proliferation (phospho-histone-H3 increased in hibernating and remote regions with a concomitant increase in myocyte nuclear density. These effects were accompanied by reductions in myocyte diameter consistent with new myocyte formation. Only rare myocytes arose from sex-mismatched donor CDCs.Global icCDC infusion under continuous flow is feasible and improves contractile function, regresses myocyte cellular hypertrophy and increases myocyte proliferation in diseased but not normal hearts. New myocytes arising via differentiation of injected cells are rare, implicating stimulation of endogenous myocyte regeneration as the primary mechanism of repair.

  18. Ischemic Stroke

    OpenAIRE

    Eleni Dokoutsidou; Konstantina Antoniou

    2009-01-01

    Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etio...

  19. THE ROLE OF LIPOTROPIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE BEFORE AND AFTER CORONARY REVASCULARIZATION

    Directory of Open Access Journals (Sweden)

    R. N. Adzhiev

    2013-01-01

    Full Text Available Review of large of trials that prove the positive impact of high-dose lipid-lowering therapy on the prognosis in patients with ischemic heart disease (IHD are presented. The data on the efficacy of the lipid profile correction by lipid apheresis in patients with hypercholesterolemia that is refractory to optimal medical therapy are showed. The results of the large trials (LIPS, ARMYDA, NAPLES II, ARMYDA-RECAPTURE, Post-CABG, TNT and meta-analyzes on the role of statins, prescribed before and after coronary artery bypass surgery and stenting, in reducing the risk of early and late cardiac events and the need for repeat myocardial revascularization are analyzed. The issue of therapeutic apheresis should be considered in cases of refractory hypercholesterolemia according to ESC/EAS Guidelines for the management of dyslipidaemias (2011. The tendency to reduction in the risk of stent restenosis and vein graft lesions after lipid apheresis is found in very high risk patients with IHD and refractory hypercholesterolemia that underwent coronary stenting or bypass surgery.

  20. THE ROLE OF LIPOTROPIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE BEFORE AND AFTER CORONARY REVASCULARIZATION

    Directory of Open Access Journals (Sweden)

    R. N. Adzhiev

    2015-09-01

    Full Text Available Review of large of trials that prove the positive impact of high-dose lipid-lowering therapy on the prognosis in patients with ischemic heart disease (IHD are presented. The data on the efficacy of the lipid profile correction by lipid apheresis in patients with hypercholesterolemia that is refractory to optimal medical therapy are showed. The results of the large trials (LIPS, ARMYDA, NAPLES II, ARMYDA-RECAPTURE, Post-CABG, TNT and meta-analyzes on the role of statins, prescribed before and after coronary artery bypass surgery and stenting, in reducing the risk of early and late cardiac events and the need for repeat myocardial revascularization are analyzed. The issue of therapeutic apheresis should be considered in cases of refractory hypercholesterolemia according to ESC/EAS Guidelines for the management of dyslipidaemias (2011. The tendency to reduction in the risk of stent restenosis and vein graft lesions after lipid apheresis is found in very high risk patients with IHD and refractory hypercholesterolemia that underwent coronary stenting or bypass surgery.

  1. Outcome of Prolonged Ventricular Fibrillation and CPR in a Rat Model of Chronic Ischemic Left Ventricular Dysfunction

    Directory of Open Access Journals (Sweden)

    Xiangshao Fang

    2013-01-01

    Full Text Available Patients with chronic left ventricular (LV dysfunction are assumed to have a lower chance of successful CPR and lower likelihood of ultimate survival. However, these assumptions have rarely been documented. Therefore, we investigated the outcome of prolonged ventricular fibrillation (VF and CPR in a rat model of chronic LV dysfunction. Sprague-Dawley rats were randomized to (1 chronic LV dysfunction: animals underwent left coronary artery ligation; and (2 sham control. Echocardiography was used to measure cardiac performance before surgery and 4 weeks after surgery. Four weeks after surgical intervention, 8 min of VF was induced and defibrillation was delivered after 8 min of CPR. LV dilation and low ejection fraction were observed 4 weeks after coronary ligation. With optimal chest compressions, coronary perfusion pressure values during CPR were well maintained and indistinguishable between groups. There were no differences in resuscitability and numbers of shock required for successful resuscitation between groups. Despite the significantly decreased cardiac index in LV dysfunction animals before induction of VF, no differences in cardiac index were observed between groups following resuscitation, which was associated with the insignificant difference in postresuscitation survival. In conclusion, the outcomes of CPR were not compromised by the preexisting chronic LV dysfunction.

  2. COMPARISON OF EFFICACY AND SAFETY OF RAMIPRIL, MOLSIDOMINE AND THEIR COMBINATION IN PATIENTS WITH CHRONIC HEART FAILURE, WHICH COMPLICATED ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    I. I. Sinitsina

    2008-01-01

    Full Text Available Aim. To study effects of ramipril, molsidomine and their combinations on morphofunctional heart indices and clinical status of patients with chronic heart failure (CHF, which complicated an ischemic heart disease (IHD.Material and methods. 41 patients with CHF class II-III (NYHA, which complicated IHD (postinfarction cardiosclerosis were included in the study. Patients did not receive ACE inhibitors. Patients were split in 3 groups: patients of the 1st group received ramipril, patients of the 2nd group - molsidomine and patients of the 3rd group – combination of ramipril and molsidomine. Clinical examination, laboratory tests, electrocardiogram, cardiac ultrasonograthy, exercise tolerance test was performed before treatment and after 3 months and 1 year of treatment.Results. Improvement of clinical status and decrease of class NYHA was found in 38,5% of patients in ramipril group; in 33,3% of patients in molsidomine group and in 23,1 % of patients in combined therapy group. Increase of ejection fraction on 17 % from initial level was found in patients receiving combined therapy; on 25,2% - in patients receiving molsidomine; and on 12,4% - in patients receiving ramipril. Decrease of residual volumes of a left ventricle also was detected.Conclusion. All therapies (ramipril, molsidomine and their combination in patients with CHF class II-III and postinfarction cardiosclerosis are clinically and hemodynamically effective in long term implementation.

  3. Neuronal apoptosis and synaptic density in the dentate gyrus of ischemic rats' response to chronic mild stress and the effects of Notch signaling.

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    Shaohua Wang

    Full Text Available Our previous research highlighted an inconsistency with Notch1 signaling-related compensatory neurogenesis after chronic mild stress (CMS in rodents suffering from cerebral ischemia, which continue to display post-stroke depressive symptoms. Here, we hypothesize that CMS aggrandized ischemia-related apoptosis injury and worsened synaptic integrity via gamma secretase-meditated Notch1 signaling. Adult rats were exposed to a CMS paradigm after left middle cerebral artery occlusion (MCAO. Open-field and sucrose consumption testing were employed to assess depression-like behavior. Gene expression of pro-apoptotic Bax, anti-apoptotic Bcl-2, and synaptic density-related synaptophysin were measured by western blotting and real-time PCR on Day 28 after MCAO surgery. CMS induced depressive behaviors in ischemic rats, which was accompanied by an elevation in Bax/bcl-2 ratio, TUNEL staining in neurons and reduced synaptophysin expression in the dentate gyrus. These collective effects were reversed by the gamma-secretase inhibitor DAPT (N-[N-(3,5-difluorophenacetyl-L-alanyl]-S-phenyl-glycine t-butyl ester. We found that post-stroke stressors made neurons in the dentate gyrus vulnerable to apoptosis, which supports a putative role for Notch signaling in neural integrity, potentially in newborn cells' synaptic deficit with regard to preexisting cells. These findings suggest that post-stroke depression therapeutically benefits from blocking gamma secretase mediated Notch signaling, and whether this signaling pathway could be a therapeutic target needs to be further investigated.

  4. HYPOLIPIDEMIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN 2004-2010 ACCORDING TO THE PROGNOZ IBS REGISTER

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    S. N. Tolpygina

    2015-01-01

    Full Text Available Aim. To evaluate the frequency of prescription, efficacy and patients adherence to statin therapy in a cohort of patients with ischemic heart disease (IHD, confirmed by coronary angiography data, during the period from 2004 to 2010 based on the data from the PROGNOZ IBS register.Material and methods. The PROGNOZ IBS register database was used in the study. The data of 550 patients from a cohort of patients with the confirmed IHD, who had undergone coronary angiography from 2004 to 2008 (303 of them were on the follow-up visit were included in the final analysis.Results. Low frequency of statins prescription in patients with stable IHD prior to hospitalization in 2004-2007 and a significant improvement of its quality during the stay in a specialized cardiology unit were revealed in the PROGNOZ IBS register. The frequency of statin prescription at discharge increased from 10% to 85.5% (in most cases original drugs were used, but the prescribed doses were usually inadequate. Target blood lipid levels were not achieved in the majority of patients. The level of low density cholesterol <2.5 mmol/L at discharge was present in 6.3% of the patients (the short period of hospitalization insufficient for the achievement of statins maximum effect should be taken into consideration. 67% of patients had good adherence to lipid-lowering therapy 3.9 years after the admission, however, the original drugs had been replaced by a variety of generics in most patients. The efficacy of the therapy was inadequate: the target levels of total cholesterol (<4.5 mmol/L and low density cholesterol (<2.5 mmol/L were achieved in 40% of patients, of low density cholesterol (<2.0 mmol/l - in 15.8%.Conclusion. Low frequency of statins prescription in patients with stable IHD before the admission to the hospital, its significant growth during the stay and its reduction after the discharge were revealed. The treatment efficacy was low at all stages of the observation. Patients

  5. HYPOLIPIDEMIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN 2004-2010 ACCORDING TO THE PROGNOZ IBS REGISTER

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-09-01

    Full Text Available Aim. To evaluate the frequency of prescription, efficacy and patients adherence to statin therapy in a cohort of patients with ischemic heart disease (IHD, confirmed by coronary angiography data, during the period from 2004 to 2010 based on the data from the PROGNOZ IBS register.Material and methods. The PROGNOZ IBS register database was used in the study. The data of 550 patients from a cohort of patients with the confirmed IHD, who had undergone coronary angiography from 2004 to 2008 (303 of them were on the follow-up visit were included in the final analysis.Results. Low frequency of statins prescription in patients with stable IHD prior to hospitalization in 2004-2007 and a significant improvement of its quality during the stay in a specialized cardiology unit were revealed in the PROGNOZ IBS register. The frequency of statin prescription at discharge increased from 10% to 85.5% (in most cases original drugs were used, but the prescribed doses were usually inadequate. Target blood lipid levels were not achieved in the majority of patients. The level of low density cholesterol <2.5 mmol/L at discharge was present in 6.3% of the patients (the short period of hospitalization insufficient for the achievement of statins maximum effect should be taken into consideration. 67% of patients had good adherence to lipid-lowering therapy 3.9 years after the admission, however, the original drugs had been replaced by a variety of generics in most patients. The efficacy of the therapy was inadequate: the target levels of total cholesterol (<4.5 mmol/L and low density cholesterol (<2.5 mmol/L were achieved in 40% of patients, of low density cholesterol (<2.0 mmol/l - in 15.8%.Conclusion. Low frequency of statins prescription in patients with stable IHD before the admission to the hospital, its significant growth during the stay and its reduction after the discharge were revealed. The treatment efficacy was low at all stages of the observation. Patients

  6. The influence of concomitant diseases on a long-term prognosis in patients with chronic ischemic heart disease according to the PROGNOZ IBS register

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-12-01

    Full Text Available Aim. To study the incidence of comorbidities and their impact on the prognosis in patients with ischemic heart disease (IHD included into the PROGNOZ IBS Register.Material and methods. Data from the PROGNOZ IBS register of patients diagnosed with IHD using coronary angiography during the reference hospitalization (n=541; 432 male and 109 female was included in the analysis. 504 (93% patients were included in the survival analysis. Risk factors of cardiovascular diseases, associated with atherosclerosis, or those that were complications of IHD were considered as comorbidities as well as not cardiovascular diseases – chronic obstructive pulmonary disease, bronchial asthma andchronic kidney disease (CKD.Results. The average duration of follow-up was 7.3±2.19 years. The average number of comorbidities in patients with IHD was 1.83. Comorbidities worsened the prognosis of life: the presence of diabetes mellitus (DM increased the relative risk (RR of primary endpoint occurrence by 1.7 times, the combination of DM with hypertension – by 2.4 times, a history of stroke – by 2.3 times (p<0.05; 2 and 3 heart diseases – respectively, by 2.3 and 3.2 times (p<0.05; a combination of chronic lung diseases and CKD stages 3-5 – by 1.4 times (p=0.06; the presence of 2, 3, 4 and 5 comorbidities – respectively, by 4, 5, 6.4 and 13 times (p<0.001. The risk of death from all causes was determined by the number of concomitant cardiovascular diseases: 2 diseases increased RR by 2.3 times, 3 diseases – by 4.6 times, a combination of any 4 diseases – by 3.5 times, of 5 diseases – by 5 times (p<0.05.Conclusion. Prognosis of life in IHD patients is worsened by the presence of several comorbidities: risk factors of cardiovascular disease (DM and hypertension, cardiovascular diseases associated with atherosclerosis or those that are complications of IHD, chronic lung diseases and CKD.

  7. Impact of scar on water-perfusable tissue index in chronic ischemic heart disease - Evaluation with PET and contrast-enhanced MRI

    NARCIS (Netherlands)

    Knaapen, P.; Bonclarenko, O.; Beek, A.M.; Gotte, M.J.W.; Boellaard, R.; van der Weerdt, A.P.; de Visser, C.A.; van Rossum, A.C.; Lammertsma, A.A.; Visser, Folkert Willem

    2006-01-01

    Background: The water-perfusable tissue index (PTI) is assumed to differentiate viable myocardium from scar tissue, but histological comparisons in humans are lacking. The present study compares PTI with delayed contrast-enhanced magnetic resonance imaging (DCE-MRI), a validated marker of fibrotic t

  8. Inhalation of diluted diesel engine emission impacts heart rate variability and arrhythmia occurrence in a rat model of chronic ischemic heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Anselme, Frederic [Rouen University Hospital, Service de Cardiologie, Rouen (France); Loriot, Stephane; Henry, Jean-Paul; Thuillez, Christian; Morin, Jean-Paul [University of Rouen France, INSERM U644, School of Medicine-Pharmacy, Rouen, Cedex (France); Dionnet, Frederic [Centre d' Etudes et de Recherches Technologiques en Aerothermique et Moteurs, Saint Etienne du Rouvray (France); Napoleoni, Jean-Gerard [EMKA Technologies, Paris (France)

    2007-04-15

    Both increase in cardiac arrhythmia incidence and decrease in heart rate variability (HRV) have been described following human and experimental animal exposures to air pollutants. However, the potential causal relationship between these two factors remains unclear. Incidence of ventricular arrhythmia and HRV were evaluated during and after a 3 h period of Diesel engine exhaust exposure in ten healthy and ten chronic ischemic heart failure (CHF, 3 months after coronary ligation) Wistar rats using implantable ECG telemetry. Air pollutants were delivered to specifically designed whole body individual exposure chambers at particulate matter concentrations similar to those measured inside cabins of cars inserted in congested urban traffic. Recordings were obtained from unrestraint and unsedated vigil rats. Immediate decrease in RMSSD was observed in both healthy (6.64 {+-} 2.62 vs. 4.89 {+-} 1.67 ms, P < 0.05) and CHF rats (8.01 {+-} 0.89 vs. 6.6 {+-} 1.37 ms, P < 0.05) following exposure. An immediate 200-500% increase in ventricular premature beats was observed in CHF rats only. Whereas HRV progressively returned to baseline values within 2.5 h after exposure start, the proarrhythmic effect persisted as late as 5 h after exposure termination in CHF rats. Persistence of ventricular proarrhythmic effects after HRV normalization suggests that HRV reduction is not the mechanism of cardiac arrhythmias in this model. Our methodological approach, closely reflecting the real clinical situations, appeared to be a unique tool to provide further insight into the pathophysiological mechanisms of traffic related airborne pollution health impact. (orig.)

  9. Model dependent behaviour of pressure hypertrophied myocardium.

    Science.gov (United States)

    Cooper, G; Tomanek, R J

    1987-05-01

    Two animal models with contrasting responses to pressure overloading were used to determine whether cardiac dysfunction is a general property of pressure hypertrophied myocardium or a specific property of a particular model. Chronic progressive cardiac pressure overload was compared in (a) the left ventricle of the adult and aged spontaneously hypertensive rat, in which pressure overloading begins in the pup, and (b) the right ventricle of the adult cat, in which pressure overloading was initiated surgically in the kitten. Nine hypertensive and nine control rats were studied at 1 year of age, when hypertension is stable in this model; five hypertensive and five control rats were then studied at 2 years of age, when both groups of rats are beginning to show appreciable senile mortality. Systolic blood pressure was similarly increased in both hypertensive groups; compared with the normotensive control groups, the ratio of left ventricular to body weight was 36% and 76% higher in the 1 and 2 year old hypertensive groups respectively. During isotonic contractions of left ventricular papillary muscles the extent and velocity of shortening in muscles from the control and hypertensive rats in each group were the same, but shortening and relaxation times were prolonged in muscles from the hypertensive rats in both age groups. During isometric contractions developed tension and the rate of tension rise were the same throughout, but the time integral of active tension was increased in muscles from the hypertensive rats in both age groups. The ratio of oxygen consumption to either external work or developed tension was decreased in muscles from the hypertensive rats. In contrast to these data, previous data from the hypertrophied cat model showed reductions in both the velocity and the extent of isotonic shortening as well as in the rate and amount of isometric tension development, and prolongation of contraction was not observed. A similar but smaller decrease in the oxygen

  10. TOWARD THE QUESTION OF ISCHEMIC MYOCARDIAL DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    V. V. Kalyuzhin

    2014-01-01

    Full Text Available The authors of the review have analyzed papers published on the problem of ischemic myocardial dysfunction. They begin with a definition of the term “ischemia” (derived from two Greek words: ischō, meaning to hold back, and haima, meaning blood - a condition at which the arterial blood flow is insufficient to provide enough oxygen to prevent intracellular respiration from shifting from the aerobic to the anaerobic form. The poor rate of ATP generation from this process causes a decrease in cellular ATP, a concomitant rise in ADP, and ultimately, to depression inotropic (systolic and lusitropic (diastolic function of the affected segments of the myocardium. But with such simplicity of basic concepts, the consequences of ischemia so diverse. Influence of an ischemia on myocardial function so unequally at different patients, which is almost impossible to find two identical cases (as in the case of fingerprints. It depends on the infinite variety of lesions of coronary arteries, reperfusion (time and completeness of restoration of blood flow and reactions of a myocardium which, apparently, has considerable flexibility in its response. Ischemic myocardial dysfunction includes a number of discrete states, such as acute left ventricular failure in angina, acute myocardial infarction, ischemic cardiomyopathy, stunning, hibernation, pre- and postconditioning. There are widely differing underlying pathophysiologic states. The possibility exists that several of these states can coexist.

  11. Pig model of chronic myocardial ischemia and its investigation by ultrasonic integrated backscatter and Doppler tissue imaging

    Institute of Scientific and Technical Information of China (English)

    XU Jing; ZHAO Bao-zhen; WANG Zhong; GU Jun-yan; LU Shi-ping

    2004-01-01

    Objective: To construct an animal model of chronic ischemic myocardium, and evaluate it by ultrasonic integrated backscatter (IBS) and Doppler tissue imaging (DTI). Methods: An Ameroid constrictor was placed around the porcine left circumflex coronary artery (LCX). The calibrated average image intensity ( % AII), cyclic variation of IBS(CVIB), transmural gradient index (TGI) of CVIB in lateral- posterior wall (LPW), and DTI spectrum of LPW in left ventricular papillary muscle level short axis view (LVPM-SAM) and apical four chamber view (AP-4CV) at normal state, 2, 4,6 and 8 weeks postoperatively were measured. Results: Normal %AII, CVIB and TGI were 2.29 ± 0.32, 9.69 ± 2.22dB and 0.22 ± 0.08, respectively. The % AII increased gradually postoperatively. The CVIB decreased also gradually, and the decrease was higher in subepicardium than in subendocardium. Most of TGI decrease occurred from 2 to 4 weeks postoperatively and became zero at 8 weeks (P < O. 01 ); Normal Vs (peak systolic velocity) of AP-4CV was higher than that of LVPM-SAM ( P < 0.01 ). VE (peak early diastolic velocity) of AP-4CV was lower than that of LVPM-SAM ( P < 0.05). Vs and VE were all decreased after operation ( P < 0.01 ). The decrease of Vs in AP-4CV was greater than that in LVPM-SAM.Conclusion: The pathological changes of the myocardium in human ischemic heart disease (IHD) are similar to that of Ameriod model. IBS and DTI can detect echo changes and ventricular wall motion in chronic ischemic myocardium, and provide more information for clinical investigation and treatment of IHD.

  12. Lasers in the treatment of ischemic heart disease in China

    Science.gov (United States)

    Zhang, Yongzhen; Chen, Mingzhe

    2000-10-01

    Myocardial revascularization by laser is a new treatment modality for chronic, severe, refractory angina in the patients with coronary heart disease that is not amenable to angioplasty (PTCA) or bypass surgery (CABG). Transmyocardial revascularization (TMR), typically requiring open thoracotomy, uses laser to create channels that would directly carry blood from left ventricular cavity into the ischemic myocardium. Current data indicate that TMR may provide these patients with improvement in angina severity, quality of life, and myocardial perfusion. The greatest potential future use of TMR is as an adjunct to CABG in patients with disease that prevents bypass grafting due to lack of distal targets or a conduit. Recently, as percutaneous (catheter-based) myocardial revascularization (PMR) has been developed with laser technology that permits the creation of channels from the endocardial surface of the left ventricle. The early results with PMR seem encouraging. Randomized clinical trial has demonstrated symptomatic improvement and increased exercise capacity. The risk: benefit ratio for PMR appears to be much more favorable than that for TMR. The mechanisms of action of them have not yet been clearly elucidated, and several theories have been proposed, including channel patency, angiogenesis, denervation, and placebo effect. The challenge of TMR/PMR is related to improvement of perioperative outcomes and long-term survival without worsening of left ventricular function. In future, it may be feasible to combine TMR/PMR with intramyocardial delivery of angiogenic growth factors to induce further new blood vessel formation.

  13. Applications of laser in ischemic heart disease in China

    Science.gov (United States)

    Chen, Mingzhe; Zhang, Yongzhen

    1999-09-01

    Current data demonstrate that laser coronary angioplasty is most useful in complex lesions not well suited for percutaneous transluminal coronary angioplasty (PTCA). It is not `stand-alone' procedure, and should be considered an adjunct to PTCA or stenting. To date, there are not data supporting reduction of restenosis. Direct myocardial revascularization (DMR), either transmyocardial revascularization (TMR) or percutaneous (catheter-based) myocardial revascularization (PMR), uses laser to create channels between ischemic myocardium and left ventricular cavity. Candidates include patients with chronic, severe, refractory angina and those unable to undergo angioplasty or bypass surgery because conduits or acceptable target vessels are lacking. Although the mechanisms of action of DMR have not yet been clearly elucidated, but several theories have been proposed, including channel patency, angiogenesis, and denervation. TMR, typically requiring open thoracotomy, is effective for improving myocardial perfusion and reducing angina. Pilot studies demonstrate that clinical application of PMR is feasible and safe and effective for decreasing angina. Late sequelae also remain to be determined. An ongoing randomized clinical trial is comparing PMR with conventional medical therapy in patients with severe, refractory angina and disease unamenable to angioplasty or bypass surgery.

  14. Ischemic heart disease among subjects with and without chronic obstructive pulmonary disease – ECG-findings in a population-based cohort study

    OpenAIRE

    Nilsson, Ulf; Johansson, Bengt; Eriksson, Berne; Blomberg, Anders; Lundbäck, Bo; Lindberg, Anne

    2015-01-01

    Background Cardiovascular comorbidity in COPD is common and contributes to increased mortality. A few population-based studies indicate that ischemic electrocardiogram (ECG)-changes are more prevalent in COPD, while others do not. The aim of the present study was to estimate the presence of ischemic heart disease (IHD) in a population-based COPD-cohort in comparison with subjects without COPD. Methods All subjects with obstructive lung function (COPD, n = 993) were identified together with ag...

  15. Myocardium repair with stem cell therapy

    International Nuclear Information System (INIS)

    With the aim of assessing the efficacy of bone marrow-derived stem cells transplantation in patients with myocardial infarction and severe chronic heart failure through nuclear cardiology techniques, 15 revascularized patients were studied: nine (Group I) received autologous bone marrow-derived stem cells. The other six were controls (Group II). All underwent a clinical evaluation, radionuclide ventriculography, and gated-SPECT myocardial perfusion scintigraphy (MIBI-technetium99m, two-day protocol: dipyridamole - rest), before and three months after the procedure. At three months there was a clinical improvement in 89% of patients from Group I. The left ventricular ejection fraction increased: from 32±9% to 44±13% (p=0.03; Group I) and from 38±2% to 48±14% (p NS; Group II). The peak filling rate improved from 120±11 to 196±45 EDV/sec (p=0.03; Group I). The dipyridamole summed score diminished significantly only in Group I (from 35±5 to 23±14; p=0.02). The perfusion improvement was related to the implantation site in 60% of cases. We conclude that the bone marrow-derived stem cells transplantation is effective in patients with severe chronic heart failure of ischemic origin (au)

  16. Association between ischemic leukoaraiosis and chronic kidney disease in oldest old patients%老老年患者缺血性脑白质疏松症与慢性肾功能不全的关系

    Institute of Scientific and Technical Information of China (English)

    胡新国; 李娜; 程玲; 吴卫平; 管维平

    2011-01-01

    目的 探讨老老年患者缺血性脑白质疏松症(LA)与慢性肾功能不全(CKD)的关系.方法选择经磁共振成像证实的老老年(≥80岁)缺血性LA患者60例,均为男性,入组后根据慢性肾功能不全诊断标准[由血肌酐水平通过Cockcroft-Gault公式估算肾小球滤过率<60 ml/( min·1.73m2)]对于是否合并CKD,分为两组,分别为LA患者30例及合并CKD的LA患者30例;同时根据年龄相关白质改变(ARWMC)评定表,分别进行脑白质疏松的影像学分级,分为轻度组(1~4分),中度组(5~8分),重度组(≥9分).结果在老老年患者中,合并有CKD的LA组,脑白质损害程度以中、重度损害为主,占73.3%,而单纯缺血性LA组损害程度以轻度损害为主,占66.6%;脑白质损害轻、中、重度三组之间均有统计学差异;单因素分析中,其它的相关危险因素显示无统计学意义;结论CKD为老老年患者缺血性LA可能的独立危险因素.%Objective To investigate the relationship of chronic kidney disease(CKD) with ischemic leukoaraiosis(LA) in oldest old patients. Methods Sixty oldest old cases(>80 years) of ischemic LA diagnosed by magnetic resonance imaging were included. They were divided into ischemic LA group(30 cases) and CKD-complicated ischemic LA group(30 cases) according to the diagnostic criteria of chronic kidney disease[glomerular filtration rate 0.05). Conclusion CKD is a possible independent risk factor for oldest old patients with ischemic LA.

  17. Recent advances in the management of chronic stable angina II. Anti-ischemic therapy, options for refractory angina, risk factor reduction, and revascularization

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-08-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas, USAAbstract: The objectives in treating angina are relief of pain and prevention of disease ­progression through risk reduction. Mechanisms, indications, clinical forms, doses, and side effects of the traditional antianginal agents – nitrates, ß-blockers, and calcium channel ­blockers – are reviewed. A number of patients have contraindications or remain unrelieved from anginal discomfort with these drugs. Among newer alternatives, ranolazine, recently approved in the United States, indirectly prevents the intracellular calcium overload involved in cardiac ischemia and is a welcome addition to available treatments. None, however, are disease-modifying agents. Two options for refractory angina, enhanced external counterpulsation and spinal cord stimulation (SCS, are presented in detail. They are both well-studied and are effective means of treating at least some patients with this perplexing form of angina. Traditional modifiable risk factors for coronary artery disease (CAD – smoking, hypertension, dyslipidemia, ­diabetes, and obesity – account for most of the population-attributable risk. Individual therapy of high-risk patients differs from population-wide efforts to prevent risk factors from appearing or reducing their severity, in order to lower the national burden of disease. Current American College of Cardiology/American Heart Association guidelines to lower risk in patients with chronic angina are reviewed. The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE trial showed that in patients with stable angina, optimal medical therapy alone and percutaneous coronary intervention (PCI with medical therapy were equal in preventing myocardial infarction and death. The integration of COURAGE results into current practice is discussed. For patients who are unstable, with very high risk, with left main coronary artery lesions, in

  18. Data mining of magnetocardiograms for prediction of ischemic heart disease

    OpenAIRE

    Kangwanariyakul, Yosawin; Naenna, Thanakorn; Nantasenamat, Chanin; Tantimongcolwat, Tanawut

    2010-01-01

    Ischemic Heart Disease (IHD) is a major cause of death. Early and accurate detection of IHD along with rapid diagnosis are important for reducing the mortality rate. Magnetocardiogram (MCG) is a tool for detecting electro-physiological activity of the myocardium. MCG is a fully non-contact method, which avoids the problems of skin-electrode contact in the Electrocardiogram (ECG) method. However, the interpretation of MCG recordings is time-consuming and requires analysis by an expert. Ther...

  19. Prolonged ischemic heart disease and coronary artery bypass - relation to contractile reserve

    DEFF Research Database (Denmark)

    Kofoed, Klaus F; Bangsgaard, Regitze; Carstensen, Steen;

    2002-01-01

    OBJECTIVE: A major effect of coronary artery bypass grafting (CABG) in patients with ischemic heart disease and impaired left ventricular (LV) contractile function is believed to be an improvement in LV function due to recovery of dysfunctional, but viable myocardium. However, recent studies have...

  20. Prophylactic combined supplementation of choline and docosahexaenoic acid attenuates vascular cognitive impairment and preserves hippocampal cell viability in rat model of chronic cerebral hypoperfusion ischemic brain injury

    Directory of Open Access Journals (Sweden)

    G. Sivakumar

    2015-06-01

    Conclusion: Prophylactic combined Cho-DHA suppl. may be envisaged as an effective preventive strategy to attenuate VCI and neuronal injury in high-risk individuals susceptible for a future event of an ischemic stroke. [Int J Basic Clin Pharmacol 2015; 4(3.000: 522-530

  1. Capillary transfer constant of Gd-DTPA in the myocardium at rest and during vasodilation assessed by MRI

    DEFF Research Database (Denmark)

    Fritz-Hansen, T; Rostrup, Egill; Søndergaard, Lise;

    1998-01-01

    The purpose of this study was to determine whether the capillary transfer constant (Ki) of gadolinium-DTPA was sensitive to perfusion changes and whether ischemic regions in the myocardium could be identified using the modified Kety formula. Ki was measured at rest and during dipyridamole......-induced vasodilation in 10 healthy volunteers and in 10 patients with ischemic heart disease. Ki increased by a factor of 2.5+/-1.2 (mean +/- SD) from 55+/-16 ml 100 g(-1)min(-1) at rest to 136+/-46 ml 100 g(-1)min(-1) (P ... during vasodilation in ischemic regions (50+/-18 versus 49+/-30 ml 100 g(-1)min(-1) (P > 0.4)). Ki increased in nonischemic regions by a factor of 2.0+/-0.8 from 44+/-17 to 81+/-32 ml 100 g(-1)min(-1) during vasodilation (P transfer constant is sensitive...

  2. The Appropriate Use of Neurostimulation of the Spinal Cord and Peripheral Nervous System for the Treatment of Chronic Pain and Ischemic Diseases : The Neuromodulation Appropriateness Consensus Committee

    NARCIS (Netherlands)

    Deer, Timothy R.; Mekhail, Nagy; Provenzano, David; Pope, Jason; Krames, Elliot; Leong, Michael; Levy, Robert M.; Abejon, David; Buchser, Eric; Burton, Allen; Buvanendran, Asokumar; Candido, Kenneth; Caraway, David; Cousins, Michael; de Jongste, Micheal; Diwan, Sudhir; Eldabe, Sam; Gatzinsky, Kliment; Foreman, Robert D.; Hayek, Salim; Kim, Philip; Kinfe, Thomas; Kloth, David; Kumar, Krishna; Rizvi, Syed; Lad, Shivanand P.; Liem, Liong; Linderoth, Bengt; Mackey, Sean; McDowell, Gladstone; McRoberts, Porter; Poree, Lawrence; Prager, Joshua; Raso, Lou; Rauck, Richard; Russo, Marc; Simpson, Brian; Slavin, Konstantin; Staats, Peter; Stanton-Hicks, Michael; Verrills, Paul; Wellington, Joshua; Williams, Kayode; North, Richard

    2014-01-01

    Introduction: The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended approp

  3. Ischemia in collateral-dependent myocardium: effects of nifedipine and diltiazem in man.

    Science.gov (United States)

    Pupita, G; Mazzara, D; Centanni, M; Rimatori, C; Ferretti, G F; Dessì-Fulgheri, P; Russo, P; Rappelli, A

    1993-07-01

    It has recently been shown that ischemia in collateral-dependent myocardium may develop at a very variable threshold in anginal patients; accordingly, the aim of this study was to assess whether nifedipine and diltiazem can increase blood flow to collateralized myocardium in man. Nine patients with complete coronary occlusion filled by collaterals, with no other coronary stenosis, normal left ventricular function, and reproducibly positive exercise tests were studied. They underwent exercise tests off therapy and after acute randomized administration of nifedipine (10 mg sublingually), diltiazem (120 mg orally), and nitroglycerin (0.5 mg sublingually), the latter a drug known to increase blood flow to collateralized myocardium. Following nifedipine, time to 1 mm ST segment depression increased significantly (from 430 +/- 176 to 576 +/- 205 seconds, p pressure products were significantly lowered by both nifedipine and diltiazem. Nitroglycerin not only significantly improved time to ischemic threshold (from baseline to 666 +/- 76 seconds, p < 0.01), but also increased heart rate (from baseline to 137 +/- 16 beats/min, p < 0.01) and rate-pressure product (from baseline to 242 +/- 48 beats/min.mm Hg.10(2), p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8322695

  4. Elevated Platelet Activating Factor Level in Ischemia-Related Arrhythmia and Its Electrophysiological Effect on Myocardium

    Institute of Scientific and Technical Information of China (English)

    TAO Yong Kang; ZHAO Shui Ping; YU Pu Lin; SHI Jing; GU Cheng Dong; SUN Hong Tao; ZHANG Guo Qiang

    2013-01-01

    Objective The mechanism through which platelet activating factor (PAF) induces cardiac electrical activity and arrhythmia is not well understood and previous studies have suggested a potential involvement of ion channels in its action. The present study was aimed to clarify the role of PAF in fatal arrhythmias following acute myocardia infarction (AMI) and the underlying mechanism. Methods (1) Blood PAF levels were measured among 72 AMI patients at the time of diagnosis with AMI and 48 h later, and their electrocardiogram (ECG) was recorded continuously. (2) Ischemia simulation and surface electrocardiogram were conducted in 20 pigs and their PAF levels were measured. (3) PAF perfusion and standard microelectrode recording were performed on guinea pig papillary muscles. Results In both humans and pigs, elevated PAF levels were detected in AMI and simulated ischemia, respectively, and even higher PAF levels were found when fatal arrhythmias occurred. In guinea pig myocardium, PAF induced a shortening of action potential duration at 90% level of repolarization (APD90)under non-ischemic conditions and a more pronounced shortening under early simulated ischemic conditions. Conclusion AMI and ischemia are associated with increased PAF levels in humans and pigs, which are further raised when fatal arrhythmia follows. The effects of PAF on the myocardium may be mediated by multiple ion channels.

  5. The potential for nanotechnology to improve delivery of therapy to the acute ischemic heart.

    Science.gov (United States)

    Evans, Cameron W; Iyer, K Swaminathan; Hool, Livia C

    2016-04-01

    Treatment of acute cardiac ischemia remains an area in which there are opportunities for therapeutic improvement. Despite significant advances, many patients still progress to cardiac hypertrophy and heart failure. Timely reperfusion is critical in rescuing vulnerable ischemic tissue and is directly related to patient outcome, but reperfusion of the ischemic myocardium also contributes to damage. Overproduction of reactive oxygen species, initiation of an inflammatory response and deregulation of calcium homeostasis all contribute to injury, and difficulties in delivering a sufficient quantity of drug to the affected tissue in a controlled manner is a limitation of current therapies. Nanotechnology may offer significant improvements in this respect. Here, we review recent examples of how nanoparticles can be used to improve delivery to the ischemic myocardium, and suggest some approaches that may lead to improved therapies for acute cardiac ischemia. PMID:26980180

  6. Myocardial ischemic conditioning: Physiological aspects and clinical applications in cardiac surgery.

    Science.gov (United States)

    Bousselmi, Radhouane; Lebbi, Mohamed Anis; Ferjani, Mustapha

    2014-04-01

    Ischemia-reperfusion is a major determinant of myocardial impairment in patients undergoing cardiac surgery. The main goal of research in cardioprotection is to develop effective techniques to avoid ischemia-reperfusion lesions. Myocardial ischemic conditioning is a powerful endogenous cardioprotective phenomenon. First described in animals in 1986, myocardial ischemic conditioning consists of applying increased tolerance of the myocardium to sustained ischemia by exposing it to brief episodes of ischemia-reperfusion. Several studies have sought to demonstrate its effective cardioprotective action in humans and to understand its underlying mechanisms. Myocardial ischemic conditioning has two forms: ischemic preconditioning (IPC) when the conditioning stimulus is applied before the index ischemia and ischemic postconditioning when the conditioning stimulus is applied after it. The cardioprotective action of ischemic conditioning was reproduced by applying the ischemia-reperfusion stimulus to organs remote from the heart. This non-invasive manner of applying ischemic conditioning has led to its application in clinical settings. Clinical trials for the different forms of ischemic conditioning were mainly developed in cardiac surgery. Many studies suggest that this phenomenon can represent an interesting adjuvant to classical cardioprotection during on-pump cardiac surgery. Ischemic conditioning was also tested in interventional cardiology with interesting results. Finally, advances made in the understanding of mechanisms that underlie the cardioprotective action of ischemic conditioning have paved the way to a new form of myocardial conditioning which is pharmacological conditioning.

  7. [Ocular ischemic syndrome--a case report].

    Science.gov (United States)

    Zemba, M; Avram, Corina Ioana; Ochinciuc, Uliana; Stamate, Alina Cristina; Camburu, Raluca Lăcrămioara

    2013-01-01

    Ocular ischemic syndrome, also known as hypoperfusion/ hypotensive retinopathy or as ischemic oculopathy is a rare ocular disease determined by chronic arterial hypoperfusion through central retinal artery, posterior and anterior ciliary arteries. It is bilateral in 20% of the cases. Most often it appears due to severe occlusion of the carotid arteries (ICA, MCA>ECA), described in 1963 by Kearns and Hollenhorst. Occasionally it can be determined by the obstruction of ophtalmic artery or some arterities (Takayasu, giant cell arteritis). The risk factors are: age between 50-80 years, males (M:F = 2:1), arterial hypertension, diabetes, coronary diseases (5% of the cases develop ocular ischemic syndrome), vascular stroke, hemodialysis. The case we present is of an 63 years old man known with primary arterial hypertension, hypercholesterolemia, diabetes type 2 non insulin dependent and diagnosticated with ischemic cerebral stroke and bilateral obstruction of internal carotid arteries in march 2010, who is presenting for visual impairment in both eyes. The imaging investigations show important carotid occlusion and at the ophthalmologic evaluation there are ocular hypertension and rubeosis iridis at the right eye, optic atrophy at both eyes (complete in the right eye and partial in the left eye), with superior altitudinal visual field defect in left eye. The following diagnosis was established: Chronic ocular ischemic syndrome in both eyes with Neovascular glaucoma at the right eye, Anterior ischemic optic neuropathy at the left eye and laser panphotocoagulation at the right eye was started.

  8. Ischemic preconditioning—an unfulfilled promise

    International Nuclear Information System (INIS)

    Myocardial reperfusion injury has been identified as a key determinant of myocardial infarct size in patients undergoing percutaneous or surgical interventions. Although the molecular mechanisms underpinning reperfusion injury have been elucidated, attempts at translating this understanding into clinical benefit for patients undergoing cardiac interventions have produced mixed results. Ischemic conditioning has been applied before, during, or after an ischemic insult to the myocardium and has taken the form of local induction of ischemia or ischemia of distant tissues. Clinical studies have confirmed the safety of differing conditioning techniques, but the benefit of such techniques in reducing hard clinical event rates has produced mixed results. The aim of this article is to review the role of ischemic conditioning in patients undergoing percutaneous and surgical coronary revascularization. - Highlights: • There are a multitude of techniques for conditioning. • Conditioning has been utilized in percutaneous coronary intervention and cardiac surgery. • There is a lack of consistency in the techniques utilized and outcomes that have been measured. • The results of studies to date lack a consistency in the benefits of conditioning

  9. Ischemic preconditioning—an unfulfilled promise

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Timothy M. [Ashford & St. Peter' s Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ (United Kingdom); Waksman, Ron [Washington Hospital Centre, 110 Irving Street, Washington, DC 20010 (United States); De Silva, Kalpa; Jacques, Adam [Ashford & St. Peter' s Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ (United Kingdom); Mahmoudi, Michael, E-mail: m.mahmoudi@surrey.ac.uk [Ashford & St. Peter' s Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ (United Kingdom); University of Surrey, 13AY04, Surrey, GU2 7XH (United Kingdom)

    2015-03-15

    Myocardial reperfusion injury has been identified as a key determinant of myocardial infarct size in patients undergoing percutaneous or surgical interventions. Although the molecular mechanisms underpinning reperfusion injury have been elucidated, attempts at translating this understanding into clinical benefit for patients undergoing cardiac interventions have produced mixed results. Ischemic conditioning has been applied before, during, or after an ischemic insult to the myocardium and has taken the form of local induction of ischemia or ischemia of distant tissues. Clinical studies have confirmed the safety of differing conditioning techniques, but the benefit of such techniques in reducing hard clinical event rates has produced mixed results. The aim of this article is to review the role of ischemic conditioning in patients undergoing percutaneous and surgical coronary revascularization. - Highlights: • There are a multitude of techniques for conditioning. • Conditioning has been utilized in percutaneous coronary intervention and cardiac surgery. • There is a lack of consistency in the techniques utilized and outcomes that have been measured. • The results of studies to date lack a consistency in the benefits of conditioning.

  10. Blueberry-enriched diet protects rat heart from ischemic damage.

    Directory of Open Access Journals (Sweden)

    Ismayil Ahmet

    Full Text Available OBJECTIVES: to assess the cardioprotective properties of a blueberry enriched diet (BD. BACKGROUND: Reactive oxygen species (ROS play a major role in ischemia-related myocardial injury. The attempts to use synthetic antioxidants to block the detrimental effects of ROS have produced mixed or negative results precipitating the interest in natural products. Blueberries are readily available product with the highest antioxidant capacity among fruits and vegetables. METHODS AND RESULTS: Following 3-mo of BD or a regular control diet (CD, the threshold for mitochondrial permeability transition (t(MPT was measured in isolated cardiomyocytes obtained from young male Fischer-344 rats. Compared to CD, BD resulted in a 24% increase (p<0.001 of ROS indexed t(MPT. The remaining animals were subjected to a permanent ligation of the left descending coronary artery. 24 hrs later resulting myocardial infarction (MI in rats on BD was 22% less than in CD rats (p<0.01. Significantly less TUNEL(+ cardiomyocytes (2% vs 9% and 40% less inflammation cells were observed in the myocardial area at risk of BD compared to CD rats (p<0.01. In the subgroup of rats, after coronary ligation the original diet was either continued or switched to the opposite one, and cardiac remodeling and MI expansion were followed by serial echocardiography for 10 weeks. Measurements suggested that continuation of BD or its withdrawal after MI attenuated or accelerated rates of post MI cardiac remodeling and MI expansion. CONCLUSION: A blueberry-enriched diet protected the myocardium from induced ischemic damage and demonstrated the potential to attenuate the development of post MI chronic heart failure.

  11. A study on the kinetics of high-energy phosphates in myocardium by phosphorous nuclear magnetic resonance

    International Nuclear Information System (INIS)

    Effect of artificial blood, FC 43 (Perfluorochemicals) on the kinetics of high-energy phosphate in the myocardium was evaluated by 31P-NMR which permits a continuous and non-invasive assessment of in vivo phosphorus compounds. Cardiac perfusion was carried out on a excised rat heart with a Krebs-Henseleit modified solution and FC 43 alternately. Under the normal condition, ischemic condition, and at second perfusion amounts of intramyocardial creatine phosphoric acid, ATP, and inorganic phosphorus were determined by 31P-NMR. Coronary flow was simultaneously estimated. The ischemic state due to interruption of perfusion resulted in a decrease in creatine phosphoric acid, which was associated with an increase in inorganic phosphorus and intracellular acidosis. No change of ATP amount was observed under ischemic state. With resumption of perfusion, the levels of creatine phosphoric acid and inorganic phosphorus rapidly returned to the normal. In the group of FC 43, coronary flow was 2.68 ml/min/g of the heart weight, about 1/2 of that of the Krebs-Henseleit group (5.68 ml/min/g of the heart weight). In controls, there was no difference between the two groups concerning creatine phosphoric acid level and recovery of creatine phospohric acid level after ischemia. These results showed that FC 43 supplies sufficient oxygen, and has no effect on the kinetics of energy in the myocardium. (Ueda, J.)

  12. Off-pump coronary artery bypass surgery is associated with fewer gene expression changes in the human myocardium in comparison with on-pump surgery

    OpenAIRE

    Ghorbel, Mohamed T.; Cherif, Myriam; Mokhtari, Amir; Bruno, Vito Domenico; Caputo, Massimo; Angelini, Gianni D

    2010-01-01

    Off-pump coronary artery bypass surgery reduces the myocardial injury associated with on pump surgery with cardiopulmonary bypass (CPB) and ischemic-cardioplegic arrest (CA). We sought to find a mechanistic explanation for this by comparing the transcriptomic changes in the myocardium of patients undergoing on- and off-pump surgery. Transcriptomic analyses were performed on left ventricular biopsies obtained from patients prior to (pre-op) and after completion of all coronary anastomoses (pos...

  13. 香青兰有效部位滴丸对犬急性实验性缺血心肌的保护作用%Protective Effects of Dripping Pills of Moldavica Effective Composition on Acute Ischemic Myocardium Induced by Ligation of Coronary Artery in Dogs

    Institute of Scientific and Technical Information of China (English)

    邢建国; 康小龙; 何承辉; 赵专友; 薛桂蓬

    2011-01-01

    目的 研究香青兰有效部位滴丸对犬急性心肌缺血损伤的保护作用.方法 犬冠状动脉结扎致心肌缺血模型,香青兰有效部位滴丸低(25 mg·kg-1)、中(50 mg·kg-1)、高(100 mg·kg-1)剂量组十二指肠给药后采用心外膜电图标测心肌损伤程度(∑ST)及损伤范围(NST),采用红四氮唑(,TTC)染色法测定心肌梗死区域.测定血清中天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)活性.检测香青兰有效部位滴丸对实验动物心肌耗氧量、血压、心率(HR)及冠脉流量(CF)及冠脉阻力(CR)的影响.结果 犬急性心肌缺血形成后,十二指肠给予香青兰有效部位滴丸50、100nmg·kg-1可改善心肌缺血程度,并缩小心肌缺血范围,减少梗死心肌的范围;高剂量还降低心肌耗氧量,抑制CK-MB活性的升高.100 mg·kg-1可降低血压,但对HR、CF、CR无明显影响.结论香青兰有效部位滴丸对犬冠脉结扎所致心肌缺血性损伤具有一定保护作用.%OBJECTIVE To study the effect of the dripping pills of moldavica effective composition on acute ischemic myocardial injury induced by ligation of coronary artery in dogs. METHODS Myocardial ischemia was induced by ligation of the left coronary anterior descending artery in anaesthetized thoraco-opened dogs. The dripping pills of moldavica effective composition at 25, 50 and 100 mg · kg-1 were administrated into dodecadactylon. Epicardial electrocardiogram and quantitative histological analysis combined with red tetrazoline (TTC) staining were used to determine the range and degree of the damage induced by myocardial ischemia The activities of serum AST, LDH, and CK-MB were measured. The effects of dripping pills on blood pressure, heart rate ( HR), coronary artery flow (CF) and coronary artery resistance (CR) were observed. RESULTS 50, 100 mg·kg-1 dripping pills significantly decreased the severity of myocardial ischemia and the area of

  14. Spinal cord stimulation for ischemic heart disease

    NARCIS (Netherlands)

    DeJongste, MJL

    2000-01-01

    An increasing number of patients are suffering from angina pectoris that is chronically refractory to standard anti-ischemic treatment such as pharmacological and surgical strategies. To improve the quality of life of these severely disabled patients, without adversely affecting their prognosis, a n

  15. {sup 99m}Tc-glucarate kinetics differentiate normal, stunned, hibernating, and nonviable myocardium in a perfused rat heart model

    Energy Technology Data Exchange (ETDEWEB)

    Okada, David R. [University of Pennsylvania School of Medicine, Philadelphia, PA (United States); Liu, Zhonglin [University of Arizona School of Medicine, Tucson, AZ (United States); Johnson, Gerald; Okada, Robert D. [University of Oklahoma Health Sciences Center, Oklahoma, OK (United States); University of Tulsa, Tulsa, OK (United States); Beju, Delia [Oklahoma State University School of Medicine, Tulsa, OK (United States); Khaw, Ban An [Northeastern University, Boston, MA (United States)

    2010-10-15

    {sup 99m}Tc-glucarate is an infarct-avid imaging agent. However, patients may have mixtures of normal, irreversibly injured, stunned, and hibernating myocardium. The purposes were to determine {sup 99m}Tc-glucarate uptake and clearance kinetics in these four conditions, and its ability to determine the extent of injury. Twenty-two perfused rat hearts were studied: controls (n = 5), stunned (n = 5; 20-min no-flow followed by 5-min reflow), hibernating (n = 6; 120-min low flow at 4 ml/min), and ischemic-reperfused (n = 6; 120-min no-flow followed by reflow). {sup 99m}Tc-glucarate was then infused. Tracer activity was monitored using a NaI scintillation detector and a multichannel analyzer. Creatine kinase, electron microscopy, and triphenyltetrazolium chloride determined viability. {sup 99m}Tc-glucarate 10-min myocardial uptake was significantly greater in ischemic-reperfused (2.50 {+-} 0.09) (cpm, SEM) than in control (1.74 {+-} 0.07), stunned (1.68 {+-} 0.11), and hibernating (1.59 {+-} 0.11) (p < 0.05). Tracer retention curves for ischemic-reperfused were elevated at all time points as compared with the other groups. {sup 99m}Tc-glucarate 60-min myocardial uptake was significantly greater in ischemic-reperfused (7.60 {+-} 0.63) than in control (1.98 {+-} 0.15), stunned (1.79 {+-} 0.08), and hibernating (2.33 {+-} 0.15) (p < 0.05). The 60-min well-counted tracer activity ratio of ischemic-reperfused to control was 9:1 and corroborated the NaI detector results. Creatine kinase, triphenyltetrazolium chloride, and electron microscopy all demonstrated significantly greater injury in ischemic-reperfused compared to the other groups. An excellent correlation was observed between viability markers and tracer activity (r = 0.99 triphenyltetrazolium chloride; r = 0.90 creatine kinase). {sup 99m}Tc-glucarate activity continually and progressively increased in irreversibly injured myocardium. {sup 99m}Tc-glucarate uptake was strongly correlated with myocardial necrosis as

  16. 31P-nuclear magnetic resonance studies of chronic myocardial ischemia in the Yucatan micropig.

    Science.gov (United States)

    Rath, D P; Bailey, M; Zhang, H; Jiang, Z; Abduljalil, A M; Weisbrode, S; Hamlin, R L; Robitaille, P M

    1995-01-01

    In this work, an x-irradiation/high fat/high cholesterol diet-induced atherogenic model was invoked to examine the effects of severe diffuse atherosclerosis on myocardial metabolism in the in vivo porcine heart. This model was studied using spatially localized 31P-nuclear magnetic resonance (NMR) to monitor pH and the levels of inorganic phosphate, phosphomonoesters, creatine phosphate, and adenosine triphosphate as a function of workload transmurally in control swine and in animals suffering from chronic ischemic heart disease. These preliminary studies revealed that the development of severe atherosclerosis and the accompanying chronically diseased state produce changes in high energy phosphates and that increases in rate pressure products result in demonstrable signs of ischemia in the myocardium which span the entire left ventricular wall. Ischemic changes include a global increase in inorganic phosphate and corresponding decreases in creatine phosphate, ATP, and pH. Importantly, changes in intracellular pH are noted with even the slightest increase in workload suggesting that these diseased hearts display elevated glycolytic activity. By challenging these animals with increased cardiac workload, we directly visualize how the chronically compromised heart responds to severe oxygen challenges in a clinically relevant model of this situation. PMID:7814609

  17. Backscatter and attenuation characterization of ventricular myocardium

    Science.gov (United States)

    Gibson, Allyson Ann

    2009-12-01

    This Dissertation presents quantitative ultrasonic measurements of the myocardium in fetal hearts and adult human hearts with the goal of studying the physics of sound waves incident upon anisotropic and inhomogeneous materials. Ultrasound has been used as a clinical tool to assess heart structure and function for several decades. The clinical usefulness of this noninvasive approach has grown with our understanding of the physical mechanisms underlying the interaction of ultrasonic waves with the myocardium. In this Dissertation, integrated backscatter and attenuation analyses were performed on midgestational fetal hearts to assess potential differences in the left and right ventricular myocardium. The hearts were interrogated using a 50 MHz transducer that enabled finer spatial resolution than could be achieved at more typical clinical frequencies. Ultrasonic data analyses demonstrated different patterns and relative levels of backscatter and attenuation from the myocardium of the left ventricle and the right ventricle. Ultrasonic data of adult human hearts were acquired with a clinical imaging system and quantified by their magnitude and time delay of cyclic variation of myocardial backscatter. The results were analyzing using Bayes Classification and ROC analysis to quantify potential advantages of using a combination of two features of cyclic variation of myocardial backscatter over using only one or the other feature to distinguish between groups of subjects. When the subjects were classified based on hemoglobin A1c, the homeostasis model assessment of insulin resistance, and the ratio of triglyceride to high-density lipoprotein-cholesterol, differences in the magnitude and normalized time delay of cyclic variation of myocardial backscatter were observed. The cyclic variation results also suggested a trend toward a larger area under the ROC curve when information from magnitude and time delay of cyclic variation is combined using Bayes classification than when

  18. TREATMENT OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN REAL CLINICAL PRACTICE ACCORDING TO THE DATA FROM PROGNOZ IBS REGISTER. (Part 1

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-09-01

    Full Text Available According to the data from PROGNOZ IBS register drugs with proven efficacy in secondary prevention of cardiovascular complications (antiplatelets, β-blockers, ACE inhibitors, statins were not often prescribed in patients with stable ischemic heart disease prior to hospitalization. Significant improvement of the treatment quality was found during the cardiology hospital stay. The prescription rate of ACE inhibitors increased from 20% to 84.4%, statins - from 10% to 85.5%, β-blockers - from 20% to 91%, acetylsalicylic acid - from 74% to 96%. However, some drugs (statins have been used in inadequate doses. Low-density lipoprotein level <2.5 mmol/L was achieved at discharge only in 6.3% of patients.

  19. Circulating Endothelial-Derived Apoptotic Microparticles in the Patients with Ischemic Symptomatic Chronic Heart Failure: Relevance of Pro-Inflammatory Activation and Outcomes

    Directory of Open Access Journals (Sweden)

    Alexander E. Berezin

    2014-09-01

    Full Text Available Background: Endothelial-derived apoptotic microparticles (EMPs play a pivotal role in endothelial dysfunction in hronic Heart Failure (CHF. Objectives: The present study aimed to evaluate the association between EMPs and pro-inflammatory biomarkers, clinical status, and outcomes in the patients with ischemic CHF. Patients and Methods: This study was conducted on 154 patients with ischemic symptomatic moderate-to-severe CHF on discharge from hospital. The observation period was up to 3 years. Circulating NT-pro-BNP, TNF-alpha, sFas, and sFas ligand were determined at baseline. Flow cytometry analysis was used for quantifying the number of EMPs. All-cause mortality, CHF-related death, and CHD-re-hospitalization rate were examined. The data were analyzed using descriptive statistics, Receive Operation Characteristic Curve (ROC, and logistic regression analysis. Besides, P 0.514 n/mL and those with a low level of the biomarker (< 0.514 n/mL regarding their survival. The number of circulating EPMs independently predicted all-cause mortality (OR = 1.58; 95% CI = 1.20 – 1.88; P = 0.001, CHF-related death (OR = 1.22; 95% CI: 1.12 – 1.36; P < 0.001, and CHF-related re-hospitalization (OR = 1.20; 95% CI: 1.11 – 1.32; P < 0.001. Conclusions: Among the patients with symptoms of CHF, increased number of circulating EMPs was associated with increased 3-year CHF-related death, all-cause mortality, and risk of recurrent hospitalization due to CHF.

  20. Tracer exchange in the normal and ischemic coronary circulation

    Energy Technology Data Exchange (ETDEWEB)

    Harris, T.R.; Overholser, K.A.; Collins, J.C.

    1984-02-01

    Proper function of the coronary blood-tissue exchange system may be important in the preservation of myocardium threatened by ischemia. Studies have been undertaken in dogs aimed at elucidating the functions of this system under baseline and ischemic conditions. The exchange of (/sup 14/C) sucrose between the coronary capillaries and extravascular space has been studied with the multiple-tracer methods. Protein transport has been examined by measuring the deposition of labeled albumin and by collecting cardiac lymph. Results indicate that reduced-flow ischemia decreases functioning capillary surface area but increases permeability to small molecules and protein. Hyaluronidase and adenosine can restore flow after partial occlusion of the coronary artery. However, only hyaluronidase restores capillary surface to its baseline value. Thus, ischemic effects on exchange are not controlled merely by hemodynamic factors. Reduced-flow ischemia in the heart can induce a vascular permeability change in the lung circulation. It has been concluded that capillary and interstitial transport are altered significantly by ischemia. Preservation of the proper function of these processes may be important in protecting the ischemic myocardium.

  1. Impact of chronic kidney disease on long-term ischemic and bleeding outcomes in medically managed patients with acute coronary syndromes

    DEFF Research Database (Denmark)

    Melloni, Chiara; Cornel, Jan H; Hafley, Gail;

    2016-01-01

    AND RESULTS: We estimated creatinine clearance for 8953 medically managed acute coronary syndrome patients enrolled in the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes trial. Patients were classified by chronic kidney disease stage: normal renal...... function/mild (creatinine clearance >60 mL/min); moderate (creatinine clearance 30-60 mL/min); severe (creatinine clearance infarction or stroke; primary end point) and bleeding (Global Use...... of Strategies to Open Occluded Coronary Arteries and Thrombolysis In Myocardial Infarction bleeding) outcomes by chronic kidney disease stage and treatment allocation (prasugrel vs. clopidogrel) within each stage. Adjusted hazard ratios (95% confidence intervals) for moderate and for severe chronic kidney...

  2. Ischemic Gastropathic Ulcer Mimics Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Saleh Daher

    2016-01-01

    Full Text Available Gastric ulcer due to mesenteric ischemia is a rare clinical finding. As a result, few reports of ischemic gastric ulcers have been reported in the literature. The diagnosis of ischemic gastropathy is seldom considered in patients presenting with abdominal pain and gastric ulcers. In this case report, we describe a patient with increasing abdominal pain, weight loss, and gastric ulcers, who underwent extensive medical evaluation and whose symptoms were resistant to medical interventions. Finally he was diagnosed with chronic mesenteric ischemia, and his clinical and endoscopic abnormalities resolved after surgical revascularization of both the superior mesenteric artery and the celiac trunk.

  3. Pre- and post-synaptic sympathetic function in human hibernating myocardium

    Energy Technology Data Exchange (ETDEWEB)

    John, Anna S.; Pepper, John R.; Dreyfus, Gilles D.; Pennell, Dudley J. [Imperial College, Hammersmith Hospital, National Heart and Lung Institute, London (United Kingdom); Mongillo, Marco; Khan, Muhammad T. [Imperial College, Hammersmith Hospital, Medical Research Council Clinical Sciences Centre, London (United Kingdom); Depre, Christophe [University of Medicine and Dentistry New Jersey, Cardiovascular Research Institute, Department of Cell Biology and Molecular Medicine, New Jersey, NJ (United States); University of Medicine and Dentistry New Jersey, Cardiovascular Research Institute, Department of Medicine, New Jersey, NJ (United States); Rimoldi, Ornella E. [Imperial College, Hammersmith Hospital, National Heart and Lung Institute, London (United Kingdom); Imperial College, Hammersmith Hospital, Medical Research Council Clinical Sciences Centre, London (United Kingdom); New York Medical College, Cardiovascular Research Institute, Department of Medicine, Valhalla, NY (United States); Camici, Paolo G. [Imperial College, Hammersmith Hospital, National Heart and Lung Institute, London (United Kingdom); Imperial College, Hammersmith Hospital, Medical Research Council Clinical Sciences Centre, London (United Kingdom)

    2007-12-15

    Impaired pre-synaptic noradrenaline uptake-1 mechanism has been reported in a swine model of hibernating myocardium (HM). To ascertain whether adrenergic neuroeffector abnormalities are present in human HM, we combined functional measurements in vivo using cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) to assess pre- and post-synaptic sympathetic function. Twelve patients with coronary artery disease and chronic left ventricular (LV) dysfunction underwent CMR at baseline and 6 months after bypass for assessment of regional and global LV function and identification of segments with reversible dysfunction. Before surgery, myocardial noradrenaline uptake-1 ([{sup 11}C]meta-hydroxy-ephedrine; HED) and {beta}-adrenoceptor ({beta}-AR) density ([{sup 11}C]CGP-12177) were measured with PET. Patient PET data were compared with those in 18 healthy controls. The volume of distribution (V{sub d}) of HED in HM (47.95{+-}28.05 ml/g) and infarcted myocardium (42.69{+-}25.76 ml/g) was significantly reduced compared with controls (66.09{+-}14.48 ml/g). The V{sub d} of HED in normal myocardium (49.93{+-}20.48 ml/g) of patients was also lower than that in controls and the difference was close to statistical significance (p=0.06). Myocardial {beta}-AR density was significantly lower in HM (5.49{+-}2.35 pmol/g), infarcted (4.82{+-}2.61 pmol/g) and normal (5.86{+-}1.81 pmol/g) segments of patients compared with healthy controls (8.61{+-}1.32 pmol/g). Noradrenaline uptake-1 mechanism and {beta}-AR density are reduced in the myocardium of patients with chronic LV dysfunction and evidence of HM. The increased sympathetic activity to the heart in these patients is a generalised rather than regional phenomenon which is likely to contribute to the remodelling process of the whole LV rather than playing a causative role in HM. (orig.)

  4. The effect of Allium sativum on ischemic preconditioning and ischemia reperfusion induced cardiac injury

    Directory of Open Access Journals (Sweden)

    Bhatti Rajbir

    2008-01-01

    Full Text Available In the present study, the effect of garlic (Allium sativum extract on ischemic preconditioning and ischemia-reperfusion induced cardiac injury has been studied. Hearts from adult albino rats of Wistar strain were isolated and immediately mounted on Langendorff′s apparatus for retrograde perfusion. After 15 minutes of stabilization, the hearts were subjected to four episodes of 5 min ischemia, interspersed with 5 min reperfusion (to complete the protocol of ischemic preconditioning, 30 min global ischemia, followed by 120 min of reperfusion. In the control and treated groups, respective interventions were given instead of ischemic preconditioning. The magnitude of cardiac injury was quantified by measuring Lactate Dehydrogenase and creatine kinase concentration in the coronary effluent and myocardial infarct size by macroscopic volume method. Our study demonstrates that garlic extract exaggerates the cardio protection offered by ischemic preconditioning and per se treatment with garlic extract also protects the myocardium against ischemia reperfusion induced cardiac injury.

  5. Noncompaction of the Ventricular Myocardium and Polycystic Kidney Disease: A Case Report.

    Science.gov (United States)

    Fukino, Keiko; Ishiwata, Junpei; Shinohara, Hiroki; Oshima, Tsukasa; Kozaki, Tsunashi; Ikutomi, Masayasu; Amaki, Toshihiro; Nakamura, Fumitaka

    2016-06-01

    Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary disorders, characterized by the formation of multiple cysts in the kidneys and other organs, as well as noncystic manifestations such as cerebral aneurysm. The most common cardiovascular disorders associated with ADPKD include valvular abnormalities and aortic aneurysm. An association between ADPKD and impaired left ventricular function has occasionally been reported. We describe a 74-year-old woman with ADPKD and exertional dyspnea. Impaired left ventricular function resulting from noncompaction of the ventricular myocardium (NVM) and secondary left ventricular aneurysm were diagnosed. Cardiac sarcoidosis and ischemic heart disease were ruled out. Myocardial ischemia resulting from NVM was the presumptive cause of the ventricular aneurysm. To our knowledge, this is the first report of concurrent isolated NVM and left ventricular aneurysm in a patient with ADPKD. ADPKD and various cardiomyopathies, including NVM, are all reported to involve mutations of sarcomere genes, suggesting a possible link between the conditions. PMID:26873255

  6. Role of mitOKATP Channel in the Combination of Rosuvastatin and Ischemic Postcondition on Myocardium Against T2DM Rats Ischemia-Reperfusion Injury%mitOKATP通道在瑞舒伐他汀联合缺血后处理减轻糖尿病大鼠心肌缺血再灌注损伤中的作用

    Institute of Scientific and Technical Information of China (English)

    郑小芳; 吴黎明; 陈良龙

    2012-01-01

    目的 观察瑞舒伐他汀后处理联合缺血后处理是否能减轻2型糖尿病大鼠缺血再灌注损伤并探讨其相应机制.方法 建立2型糖尿病大鼠模型,并随机分成7组(每组9只):假手术组、缺血再灌注损伤组(IRI组)、瑞舒伐他汀后处理+缺血后处理组(RPO+ IPO组)、瑞舒伐他汀后处理+缺血后处理组+5-羟基喹酸盐组(5-HD组)、瑞舒伐他汀后处理+缺血后处理组+二氮嗪组(二氮嗪组)、瑞舒伐他汀后处理+缺血后处理组+ HMR-1098组(HMR-1098组)、瑞舒伐他汀后处理+缺血后处理组+克罗卡林组(克罗卡林组).进行45 min缺血和120 min再灌注,观察心肌梗死区面积及心肌细胞线粒体超微结构和血清心肌肌钙蛋白T水平.结果 RPO+ IPO组、二氮嗪组、HMR-1098组和克罗卡林组心肌梗死面积较IRI组明显减小(P<0.05),5-HD组心肌梗死面积明显大于RPO+ IPO组、二氮嗪组、HMR-1098组及克罗卡林组(P<0.05).IRI组和5-HD组心肌细胞线粒体超微结构损伤重,RPO+ IPO组、二氮嗪组、HMR-1098组及克罗卡林组心肌细胞线粒体超微结构基本完整.RPO+ IPO组、二氮嗪组、HMR-1098组及克罗卡林组血清心肌肌钙蛋白T水平较IRI组明显减少(P<0.05),5-HD组血清心肌肌钙蛋白T水平与IRI组无明显差异,但明显高于RPO+ IPO组、二氮嗪组、HMR-1098组及克罗卡林组(P<0.05).结论 瑞舒伐他汀后处理联合缺血后处理可明显减轻2型糖尿病大鼠缺血再灌注损伤,mitoKATP通道开放在此作用中起主导地位.%Aim To observe whether rosuvastatin postconditioning (RPO) and ischemic postconditioning (IPO) could attenuate ischemia-reperfusion injury (IRI) in T2DM rats, and to investigate the potential cardioprotective mechanisms involved. Methods Induced by streptozotocin plus nicotinamide, a T2DM rat model was successfully created in 54 healthy Wistar male rats, which were randomly allocated into seven groups ( n = 9) : Sham group, IRI

  7. A novel useful tool of computerized touch panel-type screening test for evaluating cognitive function of chronic ischemic stroke patients.

    Science.gov (United States)

    Deguchi, Kentaro; Kono, Syoichiro; Deguchi, Shoko; Morimoto, Nobutoshi; Kurata, Tomoko; Ikeda, Yoshio; Abe, Koji

    2013-10-01

    Cognitive and affective impairments are important non-motor features of ischemic stroke (IS) related to white-matter hyperintensity, including periventricular hyperintensity (PVH). To confirm the usefulness of a novel computerized touch panel-type screening test, we investigated cognitive and affective functioning among 142 IS patients and 105 age-and gender-matched normal control subjects. Assessment using the mini-mental state examination, Hasegawa Dementia Scale-Revised, and frontal assessment battery revealed reduced cognitive function in IS patients, with the most severe reduction exhibited by cardiogenic embolism patients, followed by lacunar infarction patients, and atherothrombotic infarction patients. Our novel touch panel screening test revealed a similar pattern of results. In addition, PVH grading, classified using Fazekas' magnetic resonance imaging method, was also correlated with cognitive decline and touch panel screening test performance. In contrast, affective function, assessed with the 15-item Geriatric Depression Scale, vitality index, and apathy scale, was not significantly decreased in IS, and did not correlate with touch panel screening test results or PVH, although the number of microbleeds was correlated with apathy scale results. The present findings revealed that IS and PVH grading were significantly correlated with decline in general cognitive status (mini-mental state examination and Hasegawa Dementia Scale-Revised) and frontal lobe function (frontal assessment battery). Performance on all touch panel screening tests was correlated with IS and PVH grading, but was largely independent of depression or apathy. Touch panel screening tests were easily understood and performed by almost all patients with mild cognitive and motor dysfunction, due to visually clear images and simple methods not involving detailed manual-handling tasks such as writing. Touch panel screening tests may provide a useful tool for the early screening of cognitive

  8. Xenotransplantation of Human Cardiomyocyte Progenitor Cells Does Not Improve Cardiac Function in a Porcine Model of Chronic Ischemic Heart Failure. Results from a Randomized, Blinded, Placebo Controlled Trial

    OpenAIRE

    Jansen of Lorkeers, SJ; Gho, Johannes M. I. H.; Koudstaal, Stefan; van Hout, Geert; Zwetsloot, Peter Paul M; van Oorschot, Joep W M; Esther C M van Eeuwijk; Leiner, Tim; Höfer, Imo E.; Goumans, Marie-José; Doevendans, Pieter A.; Sluijter, Joost P. G.; Chamuleau, Steven A J

    2015-01-01

    BACKGROUND: Recently cardiomyocyte progenitor cells (CMPCs) were successfully isolated from fetal and adult human hearts. Direct intramyocardial injection of human CMPCs (hCMPCs) in experimental mouse models of acute myocardial infarction significantly improved cardiac function compared to controls. AIM: Here, our aim was to investigate whether xenotransplantation via intracoronary infusion of fetal hCMPCs in a pig model of chronic myocardial infarction is safe and efficacious, in view of tra...

  9. The Contribution of Mannose Binding Lectin to Reperfusion Injury after Ischemic Stroke

    OpenAIRE

    Morrison, Helena; Frye, Jennifer; Davis-Gorman, Grace; Funk, Janet; McDonagh, Paul; Stahl, Gregory; Ritter, Leslie

    2011-01-01

    After complement system (CS) activation, the sequential production of complement products increases cell injury and death through opsonophagocytosis, cytolysis, adaptive, and inflammatory cell responses. These responses potentiate cerebral ischemia-reperfusion (IR) injury after ischemic stroke and reperfusion. Activation of the CS via mannose binding lectin (MBL)-initiated lectin pathway is known to increase tissue damage in response to IR in muscle, myocardium and intestine tissue. In contra...

  10. A Rare Cardiac Malformation in a Patient Presenting with Transient Ischemic Attack: Isolated Left Ventricular Diverticulum

    Directory of Open Access Journals (Sweden)

    Haldun Müderrisoğlu1

    2012-12-01

    Full Text Available Left ventricular diverticulum is a rare congenital malformation consisting of a localized protrusion of the endocardium and myocardium from the free wall of the left ventricle (LV. The prevalence of the disease is 0.26% in nonselected patients who underwent cardiac catheterization. It is believed that the etiology is an intrinsic abnormality developing during embryogenesis. It often does not cause any symptoms. We report a case of isolated left ventricular diverticulum with complaints of transient ischemic attack.

  11. Improved circulation in ocular ischemic syndrome after carotid artery stenting

    Institute of Scientific and Technical Information of China (English)

    WANG Yan-ling; ZHAO Lu; LI Ming-ming

    2011-01-01

    Ocular ischemic syndrome is a chronic ischemic eye disease including a series of ischemic ocular and brain syndromes caused by carotid artery occlusion or stenosis.Because of the different degrees of ischemia,clinical manifestations of ocular ischemic syndrome are diverse,and it is difficult to diagnose in the initial stage.The main strategy to treat ocular ischemic syndrome is elimination of carotid stenosis.We presented a patient who recovered dramatically after carotid artery stenting.The pre-stenting arm-retinal circulation time of the patient's left eye was prolonged,and a large amount of microaneurysm appeared at the posterior polar and mid-peripheral aspects of the left retina.The post-stenting arm-retinal circulation time of the left eye decreased to 16.3 seconds,and the microaneurysm almost disappeared.

  12. LONG-TERM RESULTS OF TRANSMYOCARDIAL LASER REVASCULARIZATION COMBINED WITH IMPLANTATION OF AUTOLOGOUS BONE MARROW MONONUCLEAR FRACTION IN THE TREATMENT OF CHRONIC ISCHEMIC HEART DISEAS

    Directory of Open Access Journals (Sweden)

    A. M. Chernyavsky

    2016-01-01

    Full Text Available Aim. Clinical and instrumental assessment of long-term results of autologous bone marrow cells (BMC implantation in laser channels in surgery of ischemic heart disease with diffuse and distal coronary disease.Materials and Methods. In the period of 2007–2008 35 CHD patients with diffuse and distal coronary disease underwent BMC implantation in laser channels during coronary artery bypass grafting (CABG. The control group consisted of 29 patients. All patients in this group underwent only direct myocardial revascularization (DMR. In the long-term period we examined only 30 patients of the first group. Clinical and instrumental assessment of the method efficacy was carried out in 2 weeks, 6 months and 6 years after surgery.Results. FC (NYHA mean value in indirect revascularization group significantly decreased from 2.57 ± 0.61 preoperatively to 1.77 ±0.66 in6 months after surgery (p = 0.043. After 6 years FC (NYHA was not significantly changed – 1.84 ± 0.42 (p = 0.053. Perfusion scintigraphy revealed a slight decrease of stable perfusion defect (SPD in the immediate postoperative period, a more pronounced reduction of SPD in 6 months after surgery. The average value of SPD before surgery was 20.46 ± 10.75%, in 2 weeks after the operation – 19.07 ± 9.69%, in 6 months after surgery – 15.22 ± 9.49%. In the long-term period (6 years SPD was 14.8 ± 8.43% (p = 0.047. A similar pattern was observed in the analysis of transient perfusion defect: baseline – 30 ± 2.2%, in 6 months – 15 ± 1.3%, in the long term period – 20 ± 6.1% (p = 0.047. The average value of left ventricular ejection fraction (LVEF before surgery was 55 ± 10.4%, in 2 weeks after the operation – 55.7 ± 9.3%, in 6 months – 56.7 ± 10%, after 6 years – 54 ± 12%. The dynamics is unauthentic (p = 0.068.Conclusion. BMC implantation in laser channels in addition to CABG is a safe and effective method of surgical treatment in case of CABG inability. The effect of

  13. Effects of ischemic preconditioning on ischemia/reperfusion-induced arrhythmias by upregulatation of connexin 43 expression

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    Chen Zhenguang

    2011-06-01

    Full Text Available Abstract Background The susceptibility of hypertrophied myocardium to ischemia-reperfusion injury is associated with increased risk of postoperative arrhythmias. We investigate the effects of ischemic preconditioning (IP on post-ischemic reperfusion arrhythmias in hypertrophic rabbit hearts. Methods Thirty-three rabbit models of myocardial hypertrophy were randomly divided into three groups of 11 each: non-ischemia-reperfusion group (group A, ischemia-reperfusion group (group B, and ischemic preconditioning group (group C. Another ten healthy rabbits with normal myocardium served as the healthy control group. Rabbit models of myocardial hypertrophy were induced by abdominal aortic banding. Surface electrocardiogram (ECG was recorded and Curtis-Ravingerova score was used for arrhythmia quantification. Connexin 43 (Cx43 expression was assessed by immunohistochemistry. Results Ratios of heart weight to body weight and left ventricular weight to body weight increase significantly in the three groups compared with the healthy control group (p Conclusions The incidence of ischemia/reperfusion-induced arrhythmias in hypertrophic rabbit hearts decreases after IP, which plays an important protecting role on the electrophysiology of hypertrophied myocardium by up-regulating the expression of Cx43.

  14. Metastatic Midgut Carcinoid in the Myocardium.

    Science.gov (United States)

    Bukowczan, Jakub; Lois, Konstantinos B; Skinner, Jane; Petrides, George; James, Robert Andrew; Perros, Petros

    2015-09-01

    Metastasis of neuroendocrine tumor to the myocardium is rare. We present a case of 64-year-old woman, who presented initially with abdominal pain and large adnexal mass. The image-guided biopsy showed low-grade neuroendocrine tumor with Ki67 less than 2% within the ovarian tissue. CT staging revealed bilateral adnexal masses, liver metastases, and primary lesion in the terminal ileum. Octreoscan showed marked tracer uptake within the lower esophagus not related to obvious mass on CT scan; the echocardiography confirmed the presence of a 2.7 cm LV/LA mass. In this case, close correlation between ECHO and the octreoscan obviated need for myocardial biopsy. PMID:26164175

  15. Development of a preclinical model of ischemic cardiomyopathy in swine

    OpenAIRE

    Ishikawa, Kiyotake; Ladage, Dennis; Takewa, Yoshiaki; Yaniz, Elisa; Chen, Jiqiu; Tilemann, Lisa; Sakata, Susumu; Badimon, Juan J; Hajjar, Roger J.; Kawase, Yoshiaki

    2011-01-01

    A number of promising therapies for ischemic cardiomyopathy are emerging, and the role of translational research in testing the efficacy and safety of these agents in relevant clinical models has become important. The goal of this study was to develop a chronic model of ischemic cardiomyopathy in a large animal model. In this study, 40 consecutive pigs were initially enrolled. To induce progressive stenosis, a plastic occluder with a fixed diameter of 1.0 mm fitted with an 18-gauge copper wir...

  16. Xenotransplantation of Human Cardiomyocyte Progenitor Cells Does Not Improve Cardiac Function in a Porcine Model of Chronic Ischemic Heart Failure. Results from a Randomized, Blinded, Placebo Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Sanne J Jansen of Lorkeers

    Full Text Available Recently cardiomyocyte progenitor cells (CMPCs were successfully isolated from fetal and adult human hearts. Direct intramyocardial injection of human CMPCs (hCMPCs in experimental mouse models of acute myocardial infarction significantly improved cardiac function compared to controls.Here, our aim was to investigate whether xenotransplantation via intracoronary infusion of fetal hCMPCs in a pig model of chronic myocardial infarction is safe and efficacious, in view of translation purposes.We performed a randomized, blinded, placebo controlled trial. Four weeks after ischemia/reperfusion injury by 90 minutes of percutaneous left anterior descending artery occlusion, pigs (n = 16, 68.5 ± 5.4 kg received intracoronary infusion of 10 million fetal hCMPCs or placebo. All animals were immunosuppressed by cyclosporin (CsA. Four weeks after infusion, endpoint analysis by MRI displayed no difference in left ventricular ejection fraction, left ventricular end diastolic and left ventricular end systolic volumes between both groups. Serial pressure volume (PV-loop and echocardiography showed no differences in functional parameters between groups at any timepoint. Infarct size at follow-up, measured by late gadolinium enhancement MRI showed no difference between groups. Intracoronary pressure and flow measurements showed no signs of coronary obstruction 30 minutes after cell infusion. No premature death occurred in cell treated animals.Xenotransplantation via intracoronary infusion of hCMPCs is feasible and safe, but not associated with improved left ventricular performance and infarct size compared to placebo in a porcine model of chronic myocardial infarction.

  17. Contribution to the study of thallium 201 myocardium scintigraphy

    International Nuclear Information System (INIS)

    In this work a new isotope was tested in the field of myocardium scintigraphy: thallium 201. The different radioisotopes used so far in myocardium scintigraphy are reviewed to begin with. The main biological and physical characteristics of thallium and the scintillation camera used for this work are described next. In our opinion thallium 201 owing to its biological behavior similar to that of potassium and to its physical characteristics, appears as one of the better -if not the best- known tracer suitable for use in myocardium scintigraphy. Its properties are suited to the use of a scintillation camera, which considerably shortens the examination time and thus allows an isotopic exploration of the myocardium from several incidences. The only disadvantage of this cyclotron-produced isotope seems to be its high price which will probably limit its use on a large scale. Fifty thallium 201 myocardium scintigraphs were practised on forty-eight coronary thrombosis patients. From this was established a precise topographic correlation between the electrocardiographic diagnosis and the scintigraph. The two corresponded in 47 cases out of 50. The few disagreements between ECG and scintigraphic results seem to be due either to poor-quality images or to an overall myocardium hypofixation connected with a very extensive necrosis. This means that thallium 201 myocardium scintigraphy is a reliable method of examination in the great majority of cases, giving a direct picture of the heart muscle and its necrotic lesions

  18. Resilience in Patients with Ischemic Heart Disease

    OpenAIRE

    Conceição Maria Martins de Lemos; David William Moraes; Lucia Campos Pellanda

    2016-01-01

    Background: Resilience is a psychosocial factor associated with clinical outcomes in chronic diseases. The relationship between this protective factor and certain diseases, such heart diseases, is still under-explored. Objective: The present study sought to investigate the frequency of resilience in individuals with ischemic heart disease. Method: This was a cross-sectional study with 133 patients of both genders, aged between 35 and 65 years, treated at Rio Grande do Sul Cardiology Institu...

  19. Study on the relation between ischemic chronic heart failure and anemia%缺血性慢性心力衰竭与贫血的相关性研究

    Institute of Scientific and Technical Information of China (English)

    黄自平; 郑刚; 王静; 李斌

    2011-01-01

    Objective To study the relation between ischemic chronic heart failure(CHF) and anemia. Methods 196 patients were divided into anemia group(54 cases) and non- anemia group(142 cases) according to hemoglobin levels. The clinical characteristics and prognosis between the two groups were compared. The incidence and hematological examination results of anemia between the patients with mild and severe CHF were compared. Results Fifty-four cases had anemia (27.6 %). There was significant difference in incidence rate of anemia between patients with mild and severe CHF(16.0% vs 39.6 %, P < 0.01). There were significant differences in the number of males,age, serum creatinine and the levels of LVEF between the two groups (P < 0.05, P <0.01). Compared with non-anemia group, the rehospitalization rate, average rehospitalization days and the mortality were higher in anemia group (P< 0.05). Compared with the patients with mild CHF,the level of Hb and MCHC was significantly lower in the patients with severe CHF (P <0.05). Conclusion The patients with ischemic heart disease complicated with chronic heart failure often suffer from anemia. The degree of anemia is correlated with serverity of heart failure.Patients with CHF complicated with anemia have bad outcomes.%目的 探讨缺血性慢性心力衰竭(CHF)与贫血的相关性.方法 根据血红蛋白水平将196例患者分为贫血组54例和非贫血组142例,比较2组临床特征、预后、不同程度CHF患者贫血患病率及各项生化指标.结果 196例患者中,有54例出现贫血,占27.6%;轻度心力衰竭贫血患病率16.0%.明显低于重度心力衰竭(39.6%,P<0.01).与非贫血组比较,贫血组年龄、男性比率及血肌酐明显升高,差异有统计学意义(P<0.05,P<0.01),LVEF明显降低(P<0.05);再次住院、再住院平均天数及随访期病死率明显升高(P<0.05).与轻度心力衰竭患者比较,重度心力衰竭患者血红蛋白、红细胞平均血红蛋

  20. High expression of arachidonate 15-lipoxygenase and proinflammatory markers in human ischemic heart tissue

    International Nuclear Information System (INIS)

    Highlights: ► We found a 17-fold upregulation of ALOX15 in the ischemic heart. ► Incubation of human muscle cells in hypoxia showed a 22-fold upregulation of ALOX15. ► We observed increased levels of proinflammatory markers in ischemic heart tissue. ► Suggesting a link between ischemia and inflammation in ischemic heart biopsies. -- Abstract: A common feature of the ischemic heart and atherosclerotic plaques is the presence of hypoxia (insufficient levels of oxygen in the tissue). Hypoxia has pronounced effects on almost every aspect of cell physiology, and the nuclear transcription factor hypoxia inducible factor-1α (HIF-1α) regulates adaptive responses to low concentrations of oxygen in mammalian cells. In our recent work, we observed that hypoxia increases the proinflammatory enzyme arachidonate 15-lipoxygenase (ALOX15B) in human carotid plaques. ALOX15 has recently been shown to be present in the human myocardium, but the effect of ischemia on its expression has not been investigated. Here we test the hypothesis that ischemia of the heart leads to increased expression of ALOX15, and found an almost 2-fold increase in HIF-1α mRNA expression and a 17-fold upregulation of ALOX15 mRNA expression in the ischemic heart biopsies from patients undergoing coronary bypass surgery compared with non ischemic heart tissue. To investigate the effect of low oxygen concentration on ALOX15 we incubated human vascular muscle cells in hypoxia and showed that expression of ALOX15 increased 22-fold compared with cells incubated in normoxic conditions. We also observed increased mRNA levels of proinflammatory markers in ischemic heart tissue compared with non-ischemic controls. In summary, we demonstrate increased ALOX15 in human ischemic heart biopsies. Furthermore we demonstrate that hypoxia increases ALOX15 in human muscle cells. Our results yield important insights into the underlying association between hypoxia and inflammation in the human ischemic heart disease.

  1. Can pulsed ultrasound increase tissue damage during ischemia? A study of the effects of ultrasound on infarcted and non-infarcted myocardium in anesthetized pigs

    Directory of Open Access Journals (Sweden)

    Grins Edgars

    2005-04-01

    Full Text Available Abstract Background The same mechanisms by which ultrasound enhances thrombolysis are described in connection with non-beneficial effects of ultrasound. The present safety study was therefore designed to explore effects of beneficial ultrasound characteristics on the infarcted and non-infarcted myocardium. Methods In an open chest porcine model (n = 17, myocardial infarction was induced by ligating a coronary diagonal branch. Pulsed ultrasound of frequency 1 MHz and intensity 0.1 W/cm2 (ISATA was applied during one hour to both infarcted and non-infarcted myocardial tissue. These ultrasound characteristics are similar to those used in studies of ultrasound enhanced thrombolysis. Using blinded assessment technique, myocardial damage was rated according to histopathological criteria. Results Infarcted myocardium exhibited a significant increase in damage score compared to non-infarcted myocardium: 6.2 ± 2.0 vs. 4.3 ± 1.5 (mean ± standard deviation, (p = 0.004. In the infarcted myocardium, ultrasound exposure yielded a further significant increase of damage scores: 8.1 ± 1.7 vs. 6.2 ± 2.0 (p = 0.027. Conclusion Our results suggest an instantaneous additive effect on the ischemic damage in myocardial tissue when exposed to ultrasound of stated characteristics. The ultimate damage degree remains to be clarified.

  2. Pentaerythritol Tetranitrate Targeting Myocardial Reactive Oxygen Species Production Improves Left Ventricular Remodeling and Function in Rats With Ischemic Heart Failure.

    Science.gov (United States)

    Fraccarollo, Daniela; Galuppo, Paolo; Neuser, Jonas; Bauersachs, Johann; Widder, Julian D

    2015-11-01

    Reduced nitric oxide bioavailability contributes to progression of cardiac dysfunction and remodeling in ischemic heart failure. Clinical use of organic nitrates as nitric oxide donors is limited by development of nitrate tolerance and reactive oxygen species formation. We investigated the effects of long-term therapy with pentaerythritol tetranitrate (PETN), an organic nitrate devoid of tolerance, in rats with congestive heart failure after extensive myocardial infarction. Seven days after coronary artery ligation, rats were randomly allocated to treatment with PETN (80 mg/kg BID) or placebo for 9 weeks. Long-term PETN therapy prevented the progressive left ventricular dilatation and improved left ventricular contractile function and relaxation in rats with congestive heart failure. Mitochondrial superoxide anion production was markedly increased in the failing left ventricular myocardium and nearly normalized by PETN treatment. Gene set enrichment analysis revealed that PETN beneficially modulated the dysregulation of mitochondrial genes involved in energy metabolism, paralleled by prevention of uncoupling protein-3, thioredoxin-2, and superoxide dismutase-2 downregulation. Moreover, PETN provided a remarkable protective effect against reactive fibrosis in chronically failing hearts. Mechanistically, induction of heme oxygenase-1 by PETN prevented mitochondrial superoxide generation, NOX4 upregulation, and ensuing formation of extracellular matrix proteins in fibroblasts from failing hearts. In summary, PETN targeting reactive oxygen species generation prevented the changes of mitochondrial antioxidant enzymes and progressive fibrotic remodeling, leading to amelioration of cardiac functional performance. Therefore, PETN might be a promising therapeutic option in the treatment of ischemic heart diseases involving oxidative stress and impairment in nitric oxide bioactivity.

  3. Transient Ischemic Attack

    Medline Plus

    Full Text Available ... TIA , or transient ischemic attack, is a "mini stroke" that occurs when a blood clot blocks an ... a short time. The only difference between a stroke and TIA is that with TIA the blockage ...

  4. The vascular endothelial growth factor expression and vascular regeneration in infarcted myocardium by skeletal muscle satellite cells

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Myocardial infarction results in tissue necrosis, leading to cell loss and ultimately to cardiac failure. Implantation of skeletal muscle satellite cells into the scar area may compensate for the cell loss and provides a new strategy for infarct therapy. Vascular endothelial growth factor (VEGF) is a promising reagent for inducing myocardial angiogenesis. Skeletal myoblast transplantation has been shown to improve cardiac function in chronic heart failure models by regenerating muscle. We hypothesized that VEGF expression and vascular regeneration increased in infarcted myocardium by skeletal muscle satellite cells, which can promote vascular producing and improve survival environment in infarcted myocardium.Methods The skeletal muscle satellite cells were implanted into the infarcted myocardium in a model through ligated left anterior artery in Louis Inbrad Strain rat. Specimens were got for identifying the expression of VEGF and the density of vascular by immunochemical method at two weeks after implantation. Results The proliferation and differentiation of the skeletal muscle satellite cell was very well. The expression of VEGF was higher in the implanted group (146.83±2.49) than that in the control group (134.26±6.84) (P<0.05). The vascular density in the implanted group (13.00±1.51) was also higher than that in the control (10.68±1.79) (P<0.05). Conclusion The implanted satellite cell could excrete growth factor that would induce angiogenesis and improve cell survival environment in infarcted myocardium.

  5. Hyperspectral imaging of ischemic wounds

    Science.gov (United States)

    Gnyawali, Surya C.; Elgharably, Haytham; Melvin, James; Huang, Kun; Bergdall, Valerie; Allen, David W.; Hwang, Jeeseong; Litorja, Maritoni; Shirley, Eric; Sen, Chandan K.; Xu, Ronald

    2012-03-01

    Optical imaging has the potential to achieve high spatial resolution and high functional sensitivity in wound assessment. However, clinical acceptance of many optical imaging devices is hampered by poor reproducibility, low accuracy, and lack of biological interpretation. We developed an in vivo model of ischemic flap for non-contact assessment of wound tissue functional parameters and spectral characteristics. The model was created by elevating the bipedicle skin flaps of a domestic pig from the underlying vascular bed and inhibiting graft bed reperfusion by a silastic sheet. Hyperspectral imaging was carried out on the ischemic flap model and compared with transcutaneous oxygen tension and perfusion measurements at different positions of the wound. Hyperspectral images have also been captured continuously during a post-occlusive reactive hyperemia (PORH) procedure. Tissue spectral characteristics obtained by hyperspectral imaging correlated well with cutaneous tissue oxygen tension, blood perfusion, and microscopic changes of tissue morphology. Our experiments not only demonstrated the technical feasibility for quantitative assessment of chronic wound but also provided a potential digital phantom platform for quantitative characterization and calibration of medical optical devices.

  6. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  7. X-ray microanalysis of calcium in ischemic myocardium: a new method of rapid freezing.

    Science.gov (United States)

    Sybers, H D; Myre, C D; Myre, M V

    1983-01-01

    X-ray microanalysis of biological material is best accomplished on unfixed frozen tissue sectioned on a cryoultramicrotome. The need for ultra-rapid freezing to minimize ice crystal artifact has been well documented but is difficult to achieve without the use of potentially hazardous Isopentane or Freon 22 in liquid nitrogen slush. In the present study we employ a slurry of powdered graphite in liquid nitrogen to obtain rapid freezing of cardiac tissue. The results obtained were as good as those which are achieved with Freon 22 in liquid nitrogen, and subsequent cryoultramicrotomy produced thin sections relatively free of ice crystal artifact. Microanalysis revealed a slight increase in mitochondrial calcium as compared with cytoplasmic calcium in normal myocytes. Mitochondrial calcium concentration rose significantly after 30 min of ischemia while only a slight rise in cytoplasmic calcium occurred. These findings suggest that the techniques employed are adequate for detecting ion shifts which occur during ischemia and may be useful for determining the effects of therapeutic agents at the organellar level. PMID:6635573

  8. THE EFFECT OF ACUTE MYOCARDIUM ISCHEMIC ON HEART FUNCTION OF PREGNANCY RAT

    Institute of Scientific and Technical Information of China (English)

    郑小璞; 马爱群; 牛常民; 董安平; 韩克; 刘宇; 张炜; 耿涛

    2006-01-01

    In recent years,extensive research is underwayto investigate characteristics of coronary heart dis-ease(CHD)among women.Epidemiology has in-dicatedthat sex difference has an obvious presenceinCHD incidence and mortality.Womenprior tomenopause have a muchlower presence inincidenceof CHD[1-2].Whilethe incidence and mortality raterise significantly among post menopausal women orthose who have ovary removed,si milar to that ofsame-age men.It showed that the estrogenlevel hasa close relationship with CHD.Whilepr...

  9. Accumulation of fluorodeoxyglucose in ischemic myocardium, 2. Comparison with myocardial perfusion and regional wall motion

    Energy Technology Data Exchange (ETDEWEB)

    Tamaki, Nagara; Yonekura, Yoshiharu; Senda, Michio

    1987-10-01

    Positron emission tomography (PET) using /sup 13/N-ammonia and /sup 18/F-fluorodeoxyglucose (/sup 18/FDG) was performed in 33 patients with myocardial infarction to assess myocardial viability of ECG determined infarct segments. /sup 18/FDG uptake in infarct segments was compared with myocardial perfusion by /sup 13/N-ammonia, coronary stenosis and regional wall motion by contrast ventriculography. Increased /sup 18/FDG uptake was more often seen in patients with recent myocardial infarction (RMI) than those with old infarction (p < 0.001). /sup 18/FDG uptake was more increased in those with mild hypoperfusion (p < 0.01) and those supplied by recanalized coronary arteries (p < 0.05), suggesting that residual flow to the infarct zone may be crucial to maintain myocardial viability. In RMI, an increase in /sup 18/FDG uptake was more often observed in infarct segments with stress induced hypoperfusion (p < 0.02). Furthermore, /sup 18/FDG uptake was more increased in those with milder wall motion abnormalities (p < 0.02). However, /sup 18/FDG uptake was also observed in 31 % of those with dyskinesis. These data suggest that an increase in /sup 18/FDG uptake in infarct segments was observed in area with less severe hypoperfusion and milder regional wall motion abnormalities, indicating /sup 18/FDG uptake as a useful predictor of myocardial viability in infarct segments

  10. Computational Modeling of Healthy Myocardium in Diastole.

    Science.gov (United States)

    Nikou, Amir; Dorsey, Shauna M; McGarvey, Jeremy R; Gorman, Joseph H; Burdick, Jason A; Pilla, James J; Gorman, Robert C; Wenk, Jonathan F

    2016-04-01

    In order to better understand the mechanics of the heart and its disorders, engineers increasingly make use of the finite element method (FEM) to investigate healthy and diseased cardiac tissue. However, FEM is only as good as the underlying constitutive model, which remains a major challenge to the biomechanics community. In this study, a recently developed structurally based constitutive model was implemented to model healthy left ventricular myocardium during passive diastolic filling. This model takes into account the orthotropic response of the heart under loading. In-vivo strains were measured from magnetic resonance images (MRI) of porcine hearts, along with synchronous catheterization pressure data, and used for parameter identification of the passive constitutive model. Optimization was performed by minimizing the difference between MRI measured and FE predicted strains and cavity volumes. A similar approach was followed for the parameter identification of a widely used phenomenological constitutive law, which is based on a transversely isotropic material response. Results indicate that the parameter identification with the structurally based constitutive law is more sensitive to the assigned fiber architecture and the fit between the measured and predicted strains is improved with more realistic sheet angles. In addition, the structurally based model is capable of generating a more physiological end-diastolic pressure-volume relationship in the ventricle. PMID:26215308

  11. Murine myocardium OCT imaging with a blood substitute

    Science.gov (United States)

    Kim, Jeehyun; Villard, Joseph W.; Lee, Ho; Feldman, Marc D.; Milner, Thomas E.

    2002-06-01

    Imaging of the in vivo murine myocardium using optical coherence tomography (OCT) is described. Application of conventional techniques (e.g. MRI, Ultrasound imaging) for imaging the murine myocardium is problematic because the wall thickness is less than 1.5mm (20g mouse), and the heart rate can be as high as six-hundred beats per minute. To acquire a real-time image of the murine myocardium, OCT can provide sufficient spatial resolution (10 micrometers ) and imaging speed (1000 A-Scans/s). Strong light scattering by blood in the heart causes significant light attenuation making delineation of the endocardium-chamber boundary problematic. By replacing whole blood in the mouse with an artificial blood substitute we demonstrate significant reduction of light scattering in the murine myocardium. The results indicate a significant reduction in light scattering as whole blood hematocrit is diminished below 5%. To measure thickness change of the myocardium during one cycle, a myocardium edge detection algorithm is developed and demonstrated.

  12. Cardiomyocyte Remodeling in Atrial Fibrillation and Hibernating Myocardium: Shared Pathophysiologic Traits Identify Novel Treatment Strategies?

    Directory of Open Access Journals (Sweden)

    Brian R. Weil

    2015-01-01

    Full Text Available Atrial fibrillation (AF is the most common arrhythmia and is associated with a high risk of morbidity and mortality. However, there are limited treatment strategies for prevention of disease onset and progression. Development of novel therapies for primary and secondary prevention of AF is critical and requires improved understanding of the cellular and molecular mechanisms underlying the AF disease process. Translational and clinical studies conducted over the past twenty years have revealed that atrial remodeling in AF shares several important pathophysiologic traits with the remodeling processes exhibited by hibernating myocardium that develop in response to chronic ischemia. These shared features, which include an array of structural, metabolic, and electrophysiologic changes, appear to represent a conserved adaptive myocyte response to chronic stress that involves dedifferentiation towards a fetal phenotype to promote survival. In this review, we discuss the pathophysiology of AF, summarize studies supporting a common remodeling program in AF and hibernating myocardium, and propose future therapeutic implications of this emerging paradigm. Ultimately, better understanding of the molecular mechanisms of atrial myocyte remodeling during the onset of AF and the transition from paroxysmal to persistent stages of the disease may facilitate discovery of new therapeutic targets.

  13. Moderate ischemic mitral regurgitation after postero-lateral myocardial infarction in sheep alters left ventricular shear but not normal strain in the infarct and infarct borderzone

    Science.gov (United States)

    Ge, Liang; Wu, Yife; Soleimani, Mehrdad; Khazalpour, Michael; Takaba, Kiyoaki; Tartibi, Mehrzad; Zhang, Zhihong; Acevedo-Bolton, Gabriel; Saloner, David A.; Wallace, Arthur W.; Mishra, Rakesh; Grossi, Eugene A.; Guccione, Julius M.; Ratcliffe, Mark B.

    2016-01-01

    Background Chronic ischemic mitral regurgitation (CIMR: MR) is associated with poor outcome. Left ventricular (LV) strain after postero-lateral myocardial infarction (MI) may drive LV remodeling. Although moderate CIMR has been previously shown to effect LV remodeling, the effect of CIMR on LV strain after postero-lateral MI remains unknown. We tested the hypothesis that moderate CIMR alters LV strain after postero-lateral MI. Methods/Results Postero-lateral MI was created in 10 sheep. Cardiac MRI with tags was performed 2 weeks before and 2, 8 and 16 weeks after MI. LV and right ventricular (RV) volumes were measured and regurgitant volume indexed to body surface area (BSA; RegurgVolume Index) calculated as the difference between LV and RV stroke volumes / BSA. Three-dimensional strain was calculated. Circumferential (Ecc)and longitudinal (Ell) strains were reduced in the infarct proper, MI borderzone (BZ) and remote myocardium 16 weeks after MI. In addition, radial circumferential (Erc) and radial longitudinal (Erl) shear strains were reduced in remote myocardium but increased in the infarct and BZ 16 weeks after MI. Of all strain components, however, only Erc was effected by RegurgVolume Index (p=0.0005). There was no statistically significant effect of RegurgVolume Index on Ecc, Ell, Erl, or circumferential longitudinal shear strain (Ecl). Conclusions Moderate CIMR alters radial circumferential shear strain after postero-lateral MI in the sheep. Further studies are needed to determine the effect of shear strain on myocyte hypertrophy and the effect of mitral repair on myocardial strain. PMID:26857634

  14. Pre- and post-synaptic sympathetic function in human hibernating myocardium

    International Nuclear Information System (INIS)

    Impaired pre-synaptic noradrenaline uptake-1 mechanism has been reported in a swine model of hibernating myocardium (HM). To ascertain whether adrenergic neuroeffector abnormalities are present in human HM, we combined functional measurements in vivo using cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) to assess pre- and post-synaptic sympathetic function. Twelve patients with coronary artery disease and chronic left ventricular (LV) dysfunction underwent CMR at baseline and 6 months after bypass for assessment of regional and global LV function and identification of segments with reversible dysfunction. Before surgery, myocardial noradrenaline uptake-1 ([11C]meta-hydroxy-ephedrine; HED) and β-adrenoceptor (β-AR) density ([11C]CGP-12177) were measured with PET. Patient PET data were compared with those in 18 healthy controls. The volume of distribution (Vd) of HED in HM (47.95±28.05 ml/g) and infarcted myocardium (42.69±25.76 ml/g) was significantly reduced compared with controls (66.09±14.48 ml/g). The Vd of HED in normal myocardium (49.93±20.48 ml/g) of patients was also lower than that in controls and the difference was close to statistical significance (p=0.06). Myocardial β-AR density was significantly lower in HM (5.49±2.35 pmol/g), infarcted (4.82±2.61 pmol/g) and normal (5.86±1.81 pmol/g) segments of patients compared with healthy controls (8.61±1.32 pmol/g). Noradrenaline uptake-1 mechanism and β-AR density are reduced in the myocardium of patients with chronic LV dysfunction and evidence of HM. The increased sympathetic activity to the heart in these patients is a generalised rather than regional phenomenon which is likely to contribute to the remodelling process of the whole LV rather than playing a causative role in HM. (orig.)

  15. Enhanced Electrical Integration of Engineered Human Myocardium via Intramyocardial versus Epicardial Delivery in Infarcted Rat Hearts.

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    Kaytlyn A Gerbin

    Full Text Available Cardiac tissue engineering is a promising approach to provide large-scale tissues for transplantation to regenerate the heart after ischemic injury, however, integration with the host myocardium will be required to achieve electromechanical benefits. To test the ability of engineered heart tissues to electrically integrate with the host, 10 million human embryonic stem cell (hESC-derived cardiomyocytes were used to form either scaffold-free tissue patches implanted on the epicardium or micro-tissue particles (~1000 cells/particle delivered by intramyocardial injection into the left ventricular wall of the ischemia/reperfusion injured athymic rat heart. Results were compared to intramyocardial injection of 10 million dispersed hESC-cardiomyocytes. Graft size was not significantly different between treatment groups and correlated inversely with infarct size. After implantation on the epicardial surface, hESC-cardiac tissue patches were electromechanically active, but they beat slowly and were not electrically coupled to the host at 4 weeks based on ex vivo fluorescent imaging of their graft-autonomous GCaMP3 calcium reporter. Histologically, scar tissue physically separated the patch graft and host myocardium. In contrast, following intramyocardial injection of micro-tissue particles and suspended cardiomyocytes, 100% of the grafts detected by fluorescent GCaMP3 imaging were electrically coupled to the host heart at spontaneous rate and could follow host pacing up to a maximum of 300-390 beats per minute (5-6.5 Hz. Gap junctions between intramyocardial graft and host tissue were identified histologically. The extensive coupling and rapid response rate of the human myocardial grafts after intramyocardial delivery suggest electrophysiological adaptation of hESC-derived cardiomyocytes to the rat heart's pacemaking activity. These data support the use of the rat model for studying electromechanical integration of human cardiomyocytes, and they

  16. Clinical evaluation of ischemic heart diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kamei, Fumio (Sendai Railway Hospital (Japan))

    1983-09-01

    Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhance sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful for objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis.

  17. [Cerebral infarction and transient ischemic attack].

    Science.gov (United States)

    Sahara, Noriyuki; Kuwashiro, Takahiro; Okada, Yasushi

    2016-04-01

    Japanese Guidelines for the Management of Stroke 2015 was published. Here, we describe several points revised from the 2009 edition about "Cerebral infarction and transient ischemic attack (TIA)". The revision points are as follows; 1. Extension of possible time window of intravenous recombinant tissue-plasminogen activator treatment (from within 3 hours to within 4.5 hours); 2. Antiplatelet therapy in acute stage (dual antiplatelet therapy (DAPT) for non-cardioembolic ischemic stroke or TIA); 3. Endovascular recanalization therapy in acute stage; 4. Antiplatelet therapy in chronic stage (Cilostazol is recommended similar to aspirin or clopidogrel); 5. Non-vitamin K antagonist oral anticoagulants (NOACs) for non-valvular atrial fibrillation (NVAF) stroke or TIA patients; 6. Management of TIA. We explain the revised points of the guideline in the text.

  18. Curbing Inflammation in the Ischemic Heart Disease

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    Paulo Roberto B. Evora

    2013-01-01

    Full Text Available A modern concept considers acute coronary syndrome as an autoinflammatory disorder. From the onset to the healing stage, an endless inflammation has been presented with complex, multiple cross-talk mechanisms at the molecular, cellular, and organ levels. Inflammatory response following acute myocardial infarction has been well documented since the 1940s and 1950s, including increased erythrocyte sedimentation rate, the C-reactive protein analysis, and the determination of serum complement. It is surprising to note, based on a wide literature overview including the following 30 years (decades of 1960, 1970, and 1980, that the inflammatory acute myocardium infarction lost its focus, virtually disappearing from the literature reports. The reversal of this historical process occurs in the 1990s with the explosion of studies involving cytokines. Considering the importance of inflammation in the pathophysiology of ischemic heart disease, the aim of this paper is to present a conceptual overview in order to explore the possibility of curbing this inflammatory process.

  19. Coronary collaterals improve prognosis in patients with ischemic heart disease

    NARCIS (Netherlands)

    J.J. Regieli; J.W. Jukema; H.M. Nathoe; A.H. Zwinderman; S. ng; D.E. Grobbee; Y. van der Graaf; P.A. Doevendans

    2009-01-01

    BACKGROUND: The recruitment of coronary collateral vessels results from an endogenous adaptation to ischemic heart disease (IHD). Presence of collaterals may exert protection at the time of acute or chronic obstructive coronary disease. The protective role of collaterals in patients with extensive c

  20. Detection of viable myocardium by low dose of dobutamine cine MR imaging in miniswine

    Institute of Scientific and Technical Information of China (English)

    陆敏杰; 赵世华; 韦云青; 王诚; 蒋世良; 黄连军; 张岩; 牟峰; 孟亮; 阮英峁

    2003-01-01

    Objective To evaluate the diagnostic value of dobutamine stress magnetic resonance imaging (MRI) for myocardial viability. Methods Ten male miniswines underwent left ventriculography and coronary angiography, followed by stenosis of the left circumflex coronary artery (LCX) using ameroid constrictor. More than one month later, left ventriculography and coronary angiography were performed again, followed by cine-MRI at rest and during stress with incremental dose of dobutamine 5-20 μg·kg-1·min-1. Traditional and/or breath-hold cine-MRI were used to evaluate regional left ventricular wall motion, corresponding to basal, midventricular and apical short-axis tomograms. Regional wall motion score index (WMSI) was calculated.The miniswines were finally sacrificed for pathological examination. Triphenyl tetrazolium chloride (TTC) delineated myocardial infarction. Microscopy was used to identify myocardial cellular changes. Results One pig died, one pig suffered from aneurysm and another showed no negative findings. The other seven pigs were found with hypokinetic (n=4) or akinetic (n=3) myocardial regions related to stenosed LCX. Their mean WMSI at rest for the lateral and posteroinferior walls (ischemic regions) of the left ventricle was 2.27±0.32, as compared with 1.00±0.00 (P0.05). The pathologic examination showed viable myocardium at the ischemic regions. ConclusionLow-dose dobutamine (5μg·kg-1·min-1) recovers hypokinetic or akinetic myocardial regions, and dobutamine stress MRI can be used to detect myocardial viability.

  1. Initial experience of thallium-199 application for myocardium perfusion scintiscanning

    International Nuclear Information System (INIS)

    Pharmocokinetics of thallium-199 in organs and tissues of animals with acute coronary occlusion is studied. Defects of perfusion in the back wall of myocardium in rabbits and in the front-partition part in dogs are visualized in myocardium scintigraphy with thallium-199 in animals with occlusion of coronary atrery. Scintigrams with thallium-201 carried out in animals after coronary occlusion were identical to the results of investigations with thallium-199. It is shown that thallium-199 is not at disadvantage to thallium-201 in its pharmacokinetic properties and in quality of scintigraphic pictures obtained and it can be used to detect coronary ischemia. 1 ref

  2. Photochemically induced ischemic stroke in rats

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    Schmidt Antje

    2012-08-01

    Full Text Available Abstract Background Photothrombosis was introduced as a model of ischemic stroke by Watson et al. in 1985. In the present paper, we describe a protocol to induce photothrombotic infarcts in rats. Findings The photosensitive dye Bengal Rose is intravenously administered and a laser beam is stereotactically positioned onto the skull. Illumination through the intact skull leads to local activation of Bengal Rose, which results in free radical formation, disturbance of endothelial function and thrombus formation in illuminated small cortical vessels. Conclusions Photochemically induced infarcts cause long-term sensorimotor deficits, allow long-term survival and are particularly suitable to assess the effectiveness of neuroregenerative therapies in chronic stroke studies.

  3. Identification of chronic myocardial infarction with extracellular or intravascular contrast agents in magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Jian WANG; Hong-yu LIU; Hang L(U); Bo XIANG; Marco GRUWEL; Boguslaw TOMANEK; Roxanne DESLAURIERS; Gang-hong TIAN

    2008-01-01

    Aim: To determine whether extracellular or intravascular contrast agents could detect chronic scarred myocardium in magnetic resonance imaging (MRI). Methods: Eighteen pigs underwent a 4 week ligation of 1 or 2 diagonal coronary arteries to induce chronic myocardial infarction. The hearts were then removed and perfused in a Langendorff apparatus. Eighteen hearts were divided into 2 groups. The hearts in groups Ⅰ (n=9) and Ⅱ (n=9) 收稿日期the bolus injection of Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA, 0.05 mmol/kg) and ga-dolinium-based macromolecular agent (P792, 15 μmol/kg), respectively. First pass T2* MRI was acquired using a FLASH sequence. Delayed enhancement T1 MRI was acquired with an inversion recovery prepared TurboFLASH sequence.Results: Wash-in of both agents resulted in a sharp and dramatic T2* signal loss of scarred myocardium similar to that of normal myocardium. The magnitude and velocity of T2* signal recovery caused by wash-out of extracellular agents in normal myocardium was significantly less than that in scarred myocardium. Conversely, the T2* signal of scarred and normal myocardium recovered to plateau rapidly and simultaneously due to wash-out of intravascular agents. At the fol-lowing equilibrium, extracellular agent-enhanced T1 signal intensity was signifi-cantly greater in scarred myocardium than in normal myocardium, whereas there was no significantly statistical difference in intravascular agent-enhanced T1 sig-nal intensity between scarred and normal myocardium. Conclusion: After admin-istration of extracellular agents, wash-out T2* first-pass and delayed enhanced T1 MRI could identify scarred myocardium as a hyperenhanced region. Conversely, scarred myocardium was indistinguishable from normal myocardium during first-pass and the steady state of intravascular agents.

  4. Congestive heart failure in patients with chronic kidney disease

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    Poskurica Mileta

    2014-01-01

    Full Text Available Cardiovascular disorders are the most frequent cause of death (46-60% among patients with advanced chronic renal failure (CRF, and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF. Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°. In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable.

  5. Miocárdio não compactado, Doença de Chagas e disfunção: relato de caso Miocardio no compactado, Enfermedad de Chagas y disfunción: caso clínico Noncompaction of the myocardium, Chagas' disease and dysfunction: a case report

    Directory of Open Access Journals (Sweden)

    Ronaldo Peixoto de Mello

    2010-07-01

    Full Text Available Relatamos a associação entre a cardiopatia associada ao miocárdio não compactado do ventrículo esquerdo (MNCVE à cardiopatia chagásica crônica (CCC em paciente com clínica de insuficiência cardíaca, acidente vascular cerebral isquêmico e arritmia cardíaca. As imagens típicas de MNCVE e CCC foram documentadas pela ressonância magnética cardíaca (RMC.Relatamos la asociación entre la cardiopatía asociada al miocardio no compactado del ventrículo izquierdo (MNCVI con la cardiopatía chagásica crónica (CCC en paciente con clínica de insuficiencia cardíaca, accidente vascular cerebral isquémico y arritmia cardíaca. Las imágenes típicas de MNCVI y CCC fueron documentadas por resonancia magnética cardíaca (RMC.We report the association between heart disease associated with noncompaction of the left ventricular myocardium (NCLVM and chronic Chagas' heart disease (CCHD in a patient with heart failure, ischemic stroke and cardiac arrhythmia. Images typical of NCLVM and CCHD were documented by cardiac magnetic resonance imaging (CMRI.

  6. Miocárdio hibernante: uma realidade clínica Hibernant myocardium: a clinical reality

    Directory of Open Access Journals (Sweden)

    J.A. Marin-Neto

    1997-12-01

    Full Text Available O conceito da hibernação miocárdica implica a ocorrência de disfunção ventricular crônica, potencialmente reversível, causada por dissinergia regional, dependente de isquemia prolongada. Não tem fisiopatologia elucidada, em parte porque não existem modelos experimentais satisfatórios para seu estudo. Diversos métodos são capazes de demonstrar viabilidade miocárdica nas regiões que não exibem capacidade contrátil basal. O desmascaramento da hibernação nesses territórios pode ser feito mediante demonstração de reserva contrátil, de funcionamento normal da membrana celular, ou de metabolismo preservado. A correta identificação de miocárdio hibernante reveste-se de especial significado clínico, por suas implicações prognósticas quanto a intervenções de revascularização miocárdica, destinadas a reabilitar a função ventricular em muitos pacientes coronariopatas crônicos.Myocardial hibernation is believed to occur in ventricular dyssynergic regions chronically deprived of coronary flow enough to warrant the preservation of contractile function. Pathophysiology of this condition remains largely unclear, mainly because good experimental models for its study are still lacking. Various methods can be clinically employed to detect hibernation in patients with chronic ventricular dysfunction. These methods use the principle of unmasking contractile reserve, or are based on the demonstration of preserved membrane function or myocardium metabolism in the dyssynergic regions. The correct identification of viable hibernating myocardium is crucial in the process of deciding which coronary disease patients would potentially benefit from revascularization procedures.

  7. The effect of a heparin-based coacervate of fibroblast growth factor-2 on scarring in the infarcted myocardium.

    Science.gov (United States)

    Chu, Hunghao; Chen, Chien-Wen; Huard, Johnny; Wang, Yadong

    2013-02-01

    Effective delivery of exogenous angiogenic growth factors can provide a new therapy for ischemic diseases. However, clinical translation of growth factor therapies faces multiples challenges; the most significant one is the short half-life of the naked protein. We use heparin and a nontoxic polycation to form an injectable coacervate that protects growth factors and preserves their bioactivities. Here we report the effectiveness of fibroblast growth factor-2 (FGF2) coacervate in reducing scar burden in a mouse myocardial infarction model. The coacervate provides spatial and temporal control of the release of heparin-binding proteins. Coacervate treated animals show lower level of inflammation, fibrosis and cardiomyocyte death in the infarcted myocardium. Histological evaluation indicates that FGF2 coacervate significantly increases the number of endothelial and mural cells and results in stable capillaries and arterioles to at least 6 weeks post injection. Echocardiographic assessment shows that FGF2 coacervate promotes cardiac contractibility and inhibits ventricular dilation, suggesting that the improvement at the tissue level leads to better cardiac functions. On the contrary, identical dosage of free FGF2 shows no statistical difference from saline or vehicle control in histological or functional assessment. Overall, injection of FGF2 coacervate ameliorated the ischemic injury caused by myocardial infarction. The promising data in rodent warrant further examination of the potential of clinical translation of this technology.

  8. Calcineurin is involved in cardioprotection induced by ischemic postconditioning through attenuating endoplasmic reticulum stress

    Institute of Scientific and Technical Information of China (English)

    CHEN Yi-hong; WU Xu-dong; YAO Shu-tong; SUN Seng; LIU Xiu-hua

    2011-01-01

    Background Ischemic postconditioning (I-postC) is a newly discovered and more amenable cardioprotective strategy capable of protecting the myocardium from ischemia/reperfusion (I/R) injury.Endoplasmic reticulum (ER) is a principal site for secretary protein synthesis and calcium storage.Myocardial I/R causes ER stress and emerging studies suggest that the cardioprotection has been linked to the modulation of ER stress.The aim of the present study was to determine whether cardioprotection of I-postC involves reduction in ER stress through calcineurin pathway.Methods In the in vivo model of rat myocardial I/R,myocardial infarct size was measured by triphenyltetrazolium chloride (TTC) staining and apoptosis was detected using terminal eoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) assay.Expression of calreticulin,C/EBP homologous protein (CHOP),caspase-12,and activation of caspase-12 in myocardium were detected by Western blotting.The activity and expression of calcineurin in myocardium were also detected.Results I-postC protected the I/R heart against apoptosis,myocardial infarction,and leakage of lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB).I-postC suppressed I/R-induced ER stress,as shown by a decrease in the expression of calreticulin and CHOP,and caspase-12 activation.I-postC downregulated calcineurin activation in myocardium subjected to I/R.Conclusion I-postC protects myocardium from I/R injury by suppressing ER stress and calcineurin pathways are not associated with the I-postC-induced suppression of ER stress-related apoptosis.

  9. Analysis of a Mathematical Model of Ischemic Cutaneous wounds

    CERN Document Server

    Friedman, Avner; Xue, Chuan

    2009-01-01

    Chronic wounds represent a major public health problem affecting 6.5 million people in the United States. Ischemia represents a serious complicating factor in wound healing. In this paper we analyze a recently developed mathematical model of ischemic dermal wounds. The model consists of a coupled system of partial differential equations in the partially healed region, with the wound boundary as a free boundary. The extracellular matrix (ECM) is assumed to be viscoelastic, and the free boundary moves with the velocity of the ECM at the boundary of the open wound. The model equations involve the concentrations of oxygen, cytokines, and the densities of several types of cells. The ischemic level is represented by a parameter which appears in the boundary conditions, 0 <= gamma < 1; gamma near 1 corresponds to extreme ischemia and gamma = 0 corresponds to normal non-ischemic conditions. We establish global existence and uniqueness of the free boundary problem and study the dependence of the free boundary on...

  10. Identification of Ischemic Lesions Based on Difference Integral Maps, Comparison of Several ECG Intervals

    Science.gov (United States)

    Švehlíková, J.; Kania, M.; Turzová, M.; Hebláková, E.; Tyšler, M.; Maniewski, R.

    2009-01-01

    Ischemic changes in small areas of myocardium can be detected from difference integral maps computed from body surface potentials measured on the same subject in situations with and without manifestation of ischemia. The proposed method for their detection is the inverse solution with 2 dipoles. Surface potentials were recorded at rest and during stress on 10 patients and 3 healthy subjects. Difference integral maps were computed for 4 intervals of integration of electrocardiographic signal (QRST, QRSU, STT and STU) and their properties and applicability as input data for inverse identification of ischemic lesions were compared. The results showed that better (more reliable) inverse solutions can be obtained from difference integral maps computed either from QRST or from STT interval of integration. The average correlation between these maps was 97%. The use of the end of U wave instead of the end of T wave for interval of integration did not improve the results.

  11. Etiologic Classification in Ischemic Stroke

    OpenAIRE

    Hakan Ay

    2011-01-01

    Ischemic stroke is an etiologically heterogenous disorder. Classification of ischemic stroke etiology into categories with discrete phenotypic, therapeutic, and prognostic features is indispensible to generate consistent information from stroke research. In addition, a functional classification of stroke etiology is critical to ensure unity among physicians and comparability among studies. There are two major approaches to etiologic classification in stroke. Phenotypic systems define subtypes...

  12. Thallium-201 scintigraphy of the myocardium in connection with adenosine

    International Nuclear Information System (INIS)

    It is shown that thallium-201 SPECT studies of the myocardium performed subsequent to intravenous infusion of adenosine provide results at least as valuable as those from exercise thallium-201 scintigraphy in the diagnosis of coronary artery disease. The infusion of adenosine offers great advantages over exercise studies in that it is a standardized procedure uninfluenced by a patient's physical fitness, which can thus be used in all cases. There are quite a number of clinically tolerable untoward reactions that may be associated with discomfort but do not warrant discontinuation of the procedure. Serious, verifiable side-effects are rare and disappear immediately on termination of the infusion. The most recent research in this field has shown that newly developed compounds of 99mTc are also suitable for radionuclide studies of the myocardium with adenosine vasodilation. (orig.)

  13. Gene manipulated peritoneal cell patch repairs infarcted myocardium

    OpenAIRE

    Huang, Wei; Zhang, Dongsheng; Millard, Ronald W.; Wang, Tao; Zhao, Tiemin; Fan, Guo-Chang; Ashraf, Atif; Xu, Meifeng; ASHRAF, Muhammad; Wang, Yigang

    2009-01-01

    A gene manipulated cell patch using a homologous peritoneum substrate was developed and applied after myocardial infarction to repair scarred myocardium. We genetically engineered male rat mesenchymal stem cells (MSC) using adenoviral transduction to over-express CXCR4/green fluorescent protein (GFP) (MSCCXCR4) or MSCNull or siRNA targeting CXCR4 (MSCsiRNA). Gene expression was studied by real-time quantitative PCR (qPCR) and enzyme-linked immunosorbent assay (ELISA). Cells were cultured on e...

  14. Asymptomatic ischemic cerebral lesions

    International Nuclear Information System (INIS)

    For the purpose of studying the incidence, pathomorphology and etiology of asymptomatic ischemic cerebral lesions, we carried out a brain MRI study on 65 patients with diabetes mellitus accompanied with hypertension who are thought to belong to a high risk group of ischemic cerebrovascular diseases. Excluding the abnormality of tendon reflex due to diabetic neuropathy, sixty percent of the total patients had some mild neurological signs and symptoms, most of them was discrepancy in tendon reflex. The percentage of the patients in whom MRI disclosed some abnormalities was as high as 70%, they were lacunar stroke, multiple lacunar state, cortical infarct, and patchy high signal lesions visible only in the T2 weighted image. Lacunes or these patchy high signal lesions (considered to be the dilatation of the perivascular space or true lacunes) tended to be found along the border zone or the terminal zone. These results indicate that asymptomatic patients in whom MRI discloses the abnormalities should be considered as candidates for the future onset of multi-infarct. (author)

  15. High expression of arachidonate 15-lipoxygenase and proinflammatory markers in human ischemic heart tissue

    Energy Technology Data Exchange (ETDEWEB)

    Magnusson, Lisa U.; Lundqvist, Annika [Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Asp, Julia [Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden); Synnergren, Jane [Systems Biology Research Center, School of Life Sciences, University of Skoevde, Skoevde (Sweden); Johansson, Cecilia Thalen [Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Palmqvist, Lars [Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden); Jeppsson, Anders [Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg (Sweden); Hulten, Lillemor Mattsson, E-mail: Lillemor.Mattsson@wlab.gu.se [Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden)

    2012-07-27

    Highlights: Black-Right-Pointing-Pointer We found a 17-fold upregulation of ALOX15 in the ischemic heart. Black-Right-Pointing-Pointer Incubation of human muscle cells in hypoxia showed a 22-fold upregulation of ALOX15. Black-Right-Pointing-Pointer We observed increased levels of proinflammatory markers in ischemic heart tissue. Black-Right-Pointing-Pointer Suggesting a link between ischemia and inflammation in ischemic heart biopsies. -- Abstract: A common feature of the ischemic heart and atherosclerotic plaques is the presence of hypoxia (insufficient levels of oxygen in the tissue). Hypoxia has pronounced effects on almost every aspect of cell physiology, and the nuclear transcription factor hypoxia inducible factor-1{alpha} (HIF-1{alpha}) regulates adaptive responses to low concentrations of oxygen in mammalian cells. In our recent work, we observed that hypoxia increases the proinflammatory enzyme arachidonate 15-lipoxygenase (ALOX15B) in human carotid plaques. ALOX15 has recently been shown to be present in the human myocardium, but the effect of ischemia on its expression has not been investigated. Here we test the hypothesis that ischemia of the heart leads to increased expression of ALOX15, and found an almost 2-fold increase in HIF-1{alpha} mRNA expression and a 17-fold upregulation of ALOX15 mRNA expression in the ischemic heart biopsies from patients undergoing coronary bypass surgery compared with non ischemic heart tissue. To investigate the effect of low oxygen concentration on ALOX15 we incubated human vascular muscle cells in hypoxia and showed that expression of ALOX15 increased 22-fold compared with cells incubated in normoxic conditions. We also observed increased mRNA levels of proinflammatory markers in ischemic heart tissue compared with non-ischemic controls. In summary, we demonstrate increased ALOX15 in human ischemic heart biopsies. Furthermore we demonstrate that hypoxia increases ALOX15 in human muscle cells. Our results yield

  16. Mitogen-Activated Protein Kinases and Hypoxic/Ischemic Nephropathy

    Directory of Open Access Journals (Sweden)

    Fengbao Luo

    2016-08-01

    Full Text Available Tissue hypoxia/ischemia is a pathological feature of many human disorders including stroke, myocardial infarction, hypoxic/ischemic nephropathy, as well as cancer. In the kidney, the combination of limited oxygen supply to the tissues and high oxygen demand is considered the main reason for the susceptibility of the kidney to hypoxic/ischemic injury. In recent years, increasing evidence has indicated that a reduction in renal oxygen tension/blood supply plays an important role in acute kidney injury, chronic kidney disease, and renal tumorigenesis. However, the underlying signaling mechanisms, whereby hypoxia alters cellular behaviors, remain poorly understood. Mitogen-activated protein kinases (MAPKs are key signal-transducing enzymes activated by a wide range of extracellular stimuli, including hypoxia/ischemia. There are four major family members of MAPKs: the extracellular signal-regulated kinases-1 and -2 (ERK1/2, the c-Jun N-terminal kinases (JNK, p38 MAPKs, and extracellular signal-regulated kinase-5 (ERK5/BMK1. Recent studies, including ours, suggest that these MAPKs are differentially involved in renal responses to hypoxic/ischemic stress. This review will discuss their changes in hypoxic/ischemic pathophysiology with acute kidney injury, chronic kidney diseases and renal carcinoma.

  17. Mild hypothermia reduces cardiac post-ischemic reactive hyperemia

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    Van der Pals Jesper

    2007-02-01

    Full Text Available Abstract Background In experimentally induced myocardial infarction, mild hypothermia (33–35°C is beneficial if applied prior to ischemia or reperfusion. Hypothermia, when applied after reperfusion seems to confer little or no benefit. The mechanism by which hypothermia exerts its cell-protective effect during cardiac ischemia remains unclear. It has been hypothesized that hypothermia reduces the reperfusion damage; the additional damage incurred upon the myocardium during reperfusion. Reperfusion results in a massive increase in blood flow, reactive hyperemia, which may contribute to reperfusion damage. We postulated that hypothermia could attenuate the post-ischemic reactive hyperemia. Methods Sixteen 25–30 kg pigs, in a closed chest model, were anesthetized and temperature was established in all pigs at 37°C using an intravascular cooling catheter. The 16 pigs were then randomized to hypothermia (34°C or control (37°C. The left main coronary artery was then catheterized with a PCI guiding catheter. A Doppler flow wire was placed in the mid part of the LAD and a PCI balloon was then positioned proximal to the Doppler wire but distal to the first diagonal branch. The LAD was then occluded for ten minutes in all pigs. Coronary blood flow was measured before, during and after ischemia/reperfusion. Results The peak flow seen during post-ischemic reactive hyperemia (during the first minutes of reperfusion was significantly reduced by 43 % (p Conclusion Mild hypothermia significantly reduces post-ischemic hyperemia in a closed chest pig model. The reduction of reactive hyperemia during reperfusion may have an impact on cardiac reperfusion injury.

  18. Intracoronary Delivery of Mitochondria to the Ischemic Heart for Cardioprotection

    Science.gov (United States)

    Cowan, Douglas B.; Yao, Rouan; Akurathi, Vamsidhar; Snay, Erin R.; Thedsanamoorthy, Jerusha K.; Zurakowski, David; Ericsson, Maria; Friehs, Ingeborg; Wu, Yaotang; Levitsky, Sidney; del Nido, Pedro J.; Packard, Alan B.

    2016-01-01

    We have previously shown that transplantation of autologously derived, respiration-competent mitochondria by direct injection into the heart following transient ischemia and reperfusion enhances cell viability and contractile function. To increase the therapeutic potential of this approach, we investigated whether exogenous mitochondria can be effectively delivered through the coronary vasculature to protect the ischemic myocardium and studied the fate of these transplanted organelles in the heart. Langendorff-perfused rabbit hearts were subjected to 30 minutes of ischemia and then reperfused for 10 minutes. Mitochondria were labeled with 18F-rhodamine 6G and iron oxide nanoparticles. The labeled mitochondria were either directly injected into the ischemic region or delivered by vascular perfusion through the coronary arteries at the onset of reperfusion. These hearts were used for positron emission tomography, microcomputed tomography, and magnetic resonance imaging with subsequent microscopic analyses of tissue sections to confirm the uptake and distribution of exogenous mitochondria. Injected mitochondria were localized near the site of delivery; while, vascular perfusion of mitochondria resulted in rapid and extensive dispersal throughout the heart. Both injected and perfused mitochondria were observed in interstitial spaces and were associated with blood vessels and cardiomyocytes. To determine the efficacy of vascular perfusion of mitochondria, an additional group of rabbit hearts were subjected to 30 minutes of regional ischemia and reperfused for 120 minutes. Immediately following regional ischemia, the hearts received unlabeled, autologous mitochondria delivered through the coronary arteries. Autologous mitochondria perfused through the coronary vasculature significantly decreased infarct size and significantly enhanced post-ischemic myocardial function. In conclusion, the delivery of mitochondria through the coronary arteries resulted in their rapid

  19. Influence of diabetes on myocardial ischemic preconditioning and its mechanism

    Directory of Open Access Journals (Sweden)

    Jin-song HAN

    2011-05-01

    Full Text Available Objective To explore the influence of diabetes on myocardial ischemia reperfusion(I/R in ischemic preconditioning(IPC rats and its underlying mechanism.Methods Thirty diabetic and thirty non-diabetic SD rats were chosen and respectively divided into three groups(n=10 randomly.Sham operation group(Sham group: after thoracotomy,a thread was passed under the coronary but without ligation,and 155 min later the experiment was ended.Ischemia reperfusion group(I/R group: after thoracotomy,a thread was passed under coronary artery,wait for 35 min,and then the ligature was lightened for 30 min to produce ischemia and then followed by 90 min of reperfusion.Ischemic preconditioning group(IPC group: after thoracotomy,a collar was made by threading method,balanced for 35 min,and then the rats were subjected to 5 min of ischemia and 5 min of reperfusion for 3 cycles,followed by 30 min of ischemia and 90 min of reperfusion.The contents of serum creatine kinase(CK,lactate dehydrogenase(LDH,myocardial malonyldialdehyde(MDA,and superoxide dismutase(SOD were determined,and the extent of myocardial infarction and myocardial glucose uptake rate were also assessed before ischemia and after the end of the experiment in all groups.Results In non-diabetic rats,the CK,LDH,and MDA contents were significantly higher in I/R and IPC group than those in Sham group(P 0.05.Conclusion Diabetes may counteract the protective effect of ischemic preconditioning on myocardial ischemia reperfusion injury in rats;the mechanism may be related to the insulin resistance of myocardium.

  20. Quantitative circumferential strain analysis using adenosine triphosphate-stress/rest 3-T tagged magnetic resonance to evaluate regional contractile dysfunction in ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Masashi, E-mail: m.nakamura1230@gmail.com [Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295 (Japan); Kido, Tomoyuki [Department of Radiology, Saiseikai Matsuyama Hospital, Ehime 791-0295 (Japan); Kido, Teruhito; Tanabe, Yuki; Matsuda, Takuya; Nishiyama, Yoshiko; Miyagawa, Masao; Mochizuki, Teruhito [Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295 (Japan)

    2015-08-15

    Highlights: • Infarcted segments could be differentiated from non-ischemic and ischemic segments with high sensitivity and specificity under at rest conditions. • The time-to-peak circumferential strain values in infarcted segments were more significantly delayed than those in non-ischemic and ischemic segments. • Both circumferential strain and circumferential systolic strain rate values under ATP-stress conditions were significantly lower in ischemic segments than in non-ischemic segments. • Subtracting stress and rest circumferential strain had a higher diagnostic capability for ischemia relative to only utilizing rest or ATP-stress circumferential strain values. • A circumferential strain analysis using tagged MR can quantitatively assess contractile dysfunction in ischemic and infarcted myocardium. - Abstract: Purpose: We evaluated whether a quantitative circumferential strain (CS) analysis using adenosine triphosphate (ATP)-stress/rest 3-T tagged magnetic resonance (MR) imaging can depict myocardial ischemia as contractile dysfunction during stress in patients with suspected coronary artery disease (CAD). We evaluated whether it can differentiate between non-ischemia, myocardial ischemia, and infarction. We assessed its diagnostic performance in comparison with ATP-stress myocardial perfusion MR and late gadolinium enhancement (LGE)-MR imaging. Methods: In 38 patients suspected of having CAD, myocardial segments were categorized as non-ischemic (n = 485), ischemic (n = 74), or infarcted (n = 49) from the results of perfusion MR and LGE-MR. The peak negative CS value, peak circumferential systolic strain rate (CSR), and time-to-peak CS were measured in 16 segments. Results: A cutoff value of −12.0% for CS at rest allowed differentiation between infarcted and other segments with a sensitivity of 79%, specificity of 76%, accuracy of 76%, and an area under the curve (AUC) of 0.81. Additionally, a cutoff value of 477.3 ms for time-to-peak CS at rest

  1. Leukotriene C4 synthase and ischemic cardiovascular disease and obstructive pulmonary disease in 13,000 individuals

    DEFF Research Database (Denmark)

    Freiberg, Jacob J; Dahl, Morten; Tybjaerg-Hansen, Anne;

    2009-01-01

    Ischemic cardiovascular disease and obstructive pulmonary disease involve inflammation. Leukotrienes may be important pro-inflammatory mediators. We tested the hypothesis that the (-1072)G > A and (-444)A > C promoter polymorphisms of leukotriene C4 synthase confer risk of transient ischemic attack...... (TIA), ischemic stroke, ischemic heart disease (IHD), asthma, and chronic obstructive pulmonary disease (COPD). We genotyped individuals from the Danish general population, the Copenhagen City Heart Study, and Danish patients with IHD/coronary atherosclerosis, the Copenhagen Ischemic Heart Disease...... genotype (log-rank: p = 0.03). Cumulative incidence for ischemic stroke was also lower for (-444)CC versus AA genotype (log-rank: p = 0.04). Multifactorially adjusted hazard ratios for TIA were 5.2(95% CI:1.9-14) for (-1072)AA versus GG genotype, and 0.4(0.2-1.0) for (-444)CC versus AA genotype...

  2. Interaction between Hsp60 and Bax in normal human myocardium and in myocardium affected by dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Tykhonkova I. O.

    2009-04-01

    Full Text Available The main functional compartments of molecular chaperone Hsp60 are mitochondria and cytoplasm. Up to 30 % of Hsp60 are located in cytoplasm of cardiomyocytes. The interaction between molecular chaperone Hsp60 and proapoptotic Bax protein in the cytoplasmic fraction from normal human heart tissue has been revealed by co-immunoprecipitation in contrast to myocardium affected by dilated cardiomyopathy, where this interaction has not been observed

  3. [Cerebrolysin for acute ischemic stroke].

    Science.gov (United States)

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke. PMID:23805635

  4. [Cerebrolysin for acute ischemic stroke].

    Science.gov (United States)

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke.

  5. Features Of Daily Dynamics Of Catecholamine Level In Myocardium Under The Influence Of Low Alcohol Drinks

    Directory of Open Access Journals (Sweden)

    O.I. Kostin

    2009-09-01

    Full Text Available The research goal was to study the features of daily dynamics of adrenaline and noradrenaline content in various parts of myocardium at the rats receiving nonalcoholic and alcohol-containing beer at ordinary light regimen. Substantial increase of level of adrenaline and noradrenaline in all parts of myocardium at the rats received nonalcoholic and spirit-based beer in comparison with the control. At the rats received nonalcoholic beer, authentically higher content of adrenaline and low noradrenaline in myocardium in comparison with animals received alcohol-containing beer was observed. The circadian dynamics of catecholamine level in all parts of heart myocardium was disturbed at animals of both experimental groups in comparison with the control. The revealed disturbances of level of daily catecholamine dynamics in myocardium under the influence of beer, undoubtedly, are bound with negative action of nonalcoholic nature ingredients present in beer. Key words: adrenaline, noradrenaline, myocardium, low alcohol drinks.

  6. Repetitive stimulation of autophagy-lysosome machinery by intermittent fasting preconditions the myocardium to ischemia-reperfusion injury.

    Science.gov (United States)

    Godar, Rebecca J; Ma, Xiucui; Liu, Haiyan; Murphy, John T; Weinheimer, Carla J; Kovacs, Attila; Crosby, Seth D; Saftig, Paul; Diwan, Abhinav

    2015-01-01

    Autophagy, a lysosomal degradative pathway, is potently stimulated in the myocardium by fasting and is essential for maintaining cardiac function during prolonged starvation. We tested the hypothesis that intermittent fasting protects against myocardial ischemia-reperfusion injury via transcriptional stimulation of the autophagy-lysosome machinery. Adult C57BL/6 mice subjected to 24-h periods of fasting, every other day, for 6 wk were protected from in-vivo ischemia-reperfusion injury on a fed day, with marked reduction in infarct size in both sexes as compared with nonfasted controls. This protection was lost in mice heterozygous null for Lamp2 (coding for lysosomal-associated membrane protein 2), which demonstrate impaired autophagy in response to fasting with accumulation of autophagosomes and SQSTM1, an autophagy substrate, in the heart. In lamp2 null mice, intermittent fasting provoked progressive left ventricular dilation, systolic dysfunction and hypertrophy; worsening cardiomyocyte autophagosome accumulation and lack of protection to ischemia-reperfusion injury, suggesting that intact autophagy-lysosome machinery is essential for myocardial homeostasis during intermittent fasting and consequent ischemic cardioprotection. Fasting and refeeding cycles resulted in transcriptional induction followed by downregulation of autophagy-lysosome genes in the myocardium. This was coupled with fasting-induced nuclear translocation of TFEB (transcription factor EB), a master regulator of autophagy-lysosome machinery; followed by rapid decline in nuclear TFEB levels with refeeding. Endogenous TFEB was essential for attenuation of hypoxia-reoxygenation-induced cell death by repetitive starvation, in neonatal rat cardiomyocytes, in-vitro. Taken together, these data suggest that TFEB-mediated transcriptional priming of the autophagy-lysosome machinery mediates the beneficial effects of fasting-induced autophagy in myocardial ischemia-reperfusion injury.

  7. Repetitive stimulation of autophagy-lysosome machinery by intermittent fasting preconditions the myocardium to ischemia-reperfusion injury.

    Science.gov (United States)

    Godar, Rebecca J; Ma, Xiucui; Liu, Haiyan; Murphy, John T; Weinheimer, Carla J; Kovacs, Attila; Crosby, Seth D; Saftig, Paul; Diwan, Abhinav

    2015-01-01

    Autophagy, a lysosomal degradative pathway, is potently stimulated in the myocardium by fasting and is essential for maintaining cardiac function during prolonged starvation. We tested the hypothesis that intermittent fasting protects against myocardial ischemia-reperfusion injury via transcriptional stimulation of the autophagy-lysosome machinery. Adult C57BL/6 mice subjected to 24-h periods of fasting, every other day, for 6 wk were protected from in-vivo ischemia-reperfusion injury on a fed day, with marked reduction in infarct size in both sexes as compared with nonfasted controls. This protection was lost in mice heterozygous null for Lamp2 (coding for lysosomal-associated membrane protein 2), which demonstrate impaired autophagy in response to fasting with accumulation of autophagosomes and SQSTM1, an autophagy substrate, in the heart. In lamp2 null mice, intermittent fasting provoked progressive left ventricular dilation, systolic dysfunction and hypertrophy; worsening cardiomyocyte autophagosome accumulation and lack of protection to ischemia-reperfusion injury, suggesting that intact autophagy-lysosome machinery is essential for myocardial homeostasis during intermittent fasting and consequent ischemic cardioprotection. Fasting and refeeding cycles resulted in transcriptional induction followed by downregulation of autophagy-lysosome genes in the myocardium. This was coupled with fasting-induced nuclear translocation of TFEB (transcription factor EB), a master regulator of autophagy-lysosome machinery; followed by rapid decline in nuclear TFEB levels with refeeding. Endogenous TFEB was essential for attenuation of hypoxia-reoxygenation-induced cell death by repetitive starvation, in neonatal rat cardiomyocytes, in-vitro. Taken together, these data suggest that TFEB-mediated transcriptional priming of the autophagy-lysosome machinery mediates the beneficial effects of fasting-induced autophagy in myocardial ischemia-reperfusion injury. PMID:26103523

  8. Repeated sauna therapy attenuates ventricular remodeling after myocardial infarction in rats by increasing coronary vascularity of noninfarcted myocardium.

    Science.gov (United States)

    Sobajima, Mitsuo; Nozawa, Takashi; Shida, Takuya; Ohori, Takashi; Suzuki, Takayuki; Matsuki, Akira; Inoue, Hiroshi

    2011-08-01

    Repeated sauna therapy (ST) increases endothelial nitric oxide synthase (eNOS) activity and improves cardiac function in heart failure as well as peripheral blood flow in ischemic limbs. The present study investigates whether ST can increase coronary vascularity and thus attenuate cardiac remodeling after myocardial infarction (MI). We induced MI by ligating the left coronary artery of Wistar rats. The rats were placed in a far-infrared dry sauna at 41°C for 15 min and then at 34°C for 20 min once daily for 4 wk. Cardiac hemodynamic, histopathological, and gene analyses were performed. Despite the similar sizes of MI between the ST and non-ST groups (51.4 ± 0.3 vs. 51.1 ± 0.2%), ST reduced left ventricular (LV) end-diastolic (9.7 ± 0.4 vs. 10.7 ± 0.5 mm, P myocardial atrial natriuretic peptide mRNA levels. Vascular density was reduced in the noninfarcted myocardium of non-ST rats, and the density of cells positive for CD31 and for α-smooth muscle actin was decreased. These decreases were attenuated in ST rats compared with non-ST rats and associated with increases in myocardial eNOS and vascular endothelial growth factor mRNA levels. In conclusion, ST attenuates cardiac remodeling after MI, at least in part, through improving coronary vascularity in the noninfarcted myocardium. Repeated ST might serve as a novel noninvasive therapy for patients with MI.

  9. Assessment of potentially salvageable myocardium during acute myocardial infarction: use of postextrasystolic potentiation.

    Science.gov (United States)

    Hodgson, J M; O'Neill, W W; Laufer, N; Bourdillon, P D; Walton, J A; Pitt, B

    1984-12-01

    Twenty-three patients with evolving acute myocardial infarction (AMI) undergoing catheterization for thrombolytic therapy had interventional contrast ventriculography using programmed atrial stimulation. Postextrasystolic (PES) potentiation was present in 67% of infarct-related segments up to 9 hours after the onset of AMI. The presence of segmental potentiation was not related to time from onset of pain to ventriculography, initial ejection fraction, presence of collaterals, left ventricular end-diastolic pressure or the PES delay. In 18 patients reperfusion was successful using intracoronary streptokinase an average of 6.2 hours after the onset of AMI; in these patients repeat contrast ventriculography was performed an average of 11 days after AMI. Improved chronic segmental ventricular function was predicted by the presence of collaterals to the infarct-related artery at the time of acute catheterization (p = 0.02), but was best predicted by analysis of acute PES potentiation (p less than 0.0001). The predictive value of PES analysis was highest in segments without collaterals. Thus, atrial stimulation is safe during AMI and analysis of segmental ventricular function shows potentially viable myocardium up to 9 hours after the onset of AMI. In addition, analysis of PES segmental function can predict chronic function if reperfusion is successful, especially in segments without collaterals. PES ventriculographic analysis may allow prospective determination of which patients during AMI are most likely to benefit from acute thrombolytic therapy.

  10. Effect of mobilization of bone marrow stem cells by granulocyte colony stimulating factor on clinical symptoms, left ventricular perfusion and function in patients with severe chronic ischemic heart disease

    DEFF Research Database (Denmark)

    Wang, Yongzhong; Tägil, Kristina; Ripa, Rasmus S.;

    2005-01-01

    OBJECTIVES: A phase I safety and efficacy study with granulocyte colony stimulating factor (G-CSF) mobilization of bone marrow stem cells to induce vasculogenesis in patients with severe ischemic heart disease (IHD) was conducted. DESIGN, PATIENTS AND RESULTS: 29 patients with IHD participated...... with echocardiography. CONCLUSIONS: Treatment by G-CSF improved symptoms but not signs of myocardial ischemia in patients with severe IHD. The effects seemed related to mobilization of stem cells. An adverse effect on ejection fraction could not be excluded...... in the study. Thirteen patients were treated with G-CSF for 6 days and 16 patients served as controls. G-CSF treatment was without any serious adverse events. Four patients were 'poor mobilizers' with a maximal increase in CD34+ cells to 5,000+/-700/mL blood (mean+/-S.D.) compared to 28,900+/-5,100/mL blood...

  11. Enhanced Myocardial Vascularity and Contractility by Novel FGF-1 Transgene in a Porcine Model of Chronic Coronary Occlusion

    Directory of Open Access Journals (Sweden)

    Janet L. Parker

    2008-12-01

    Full Text Available Background: Angiogenesis gene therapy has long been sought as a novel alternative treatment for restoring the blood flow and improving the contractile function of the ischemic heart in selected clinical settings. Angiogenic fibroblast growth factor-1 (FGF-1 is a promising candidate for developing a promising gene therapy protocol due to its multipotent ability to stimulate endothelial cell (EC growth, migration, and tube formation. Despite these advantages, however, FGF gene therapy has suffered setbacks mainly due to the inefficient delivery rate of the growth factor in vivo. Given the potent angiogenic effect of FGF-1, we reasoned that constitutively synthesized minute quantities of this polypeptide hormone, when empowered with the ability to escape the cellular constraint, could freely act in a paracrine/autocrine fashion on nearby existing capillary plexuses and lead to neovascularization and restoration of the blood flow to ischemic tissues for reparative purpose. Methods: We report the direct gene transfer of a retroviral-based mammalian expression vector encoding a secreted form of FGF-1 (sp-FGF-1 for the purpose of therapeutic angiogenesis into the porcine myocardium subjected to the surgical placement of an ameroid occluder to induce the chronic coronary occlusion of the left circumflex coronary artery (LCx and regional myocardial ischemia. Coronary angiography, performed 3 weeks after surgery, confirmed the interruption of the blood flow in the LCx distal to the site of ameroid placement. Results: Immunohistochemical analysis using antibody specific to von Willebrand factor (vWF, an endothelial marker, showed a significant increase (p<0.05 in myocardial vascularity in the sp-FGF-1 hearts compared to the control (vector alone. Importantly, an assessment of the cardiac function by echocardiography, performed 3 weeks after surgery, demonstrated improved cardiac contractility due to increased left ventricular free wall contraction in the

  12. Recommendations to realise and interpret the scintigraphy of myocardium perfusion

    International Nuclear Information System (INIS)

    The purpose of these recommendations is to help the physicians in the realization and the interpretation of the tomo-scintigraphies of myocardium perfusion, when this examination is made at the patients having a known or suspected coronary incapacity. These recommendations aim to encourage the practitioners (of nuclear medicine) to reflect and to discuss the procedures applied in their services. These procedures must be also adapted, in every service, to the peculiarities of the environment and to the experiment of each one. (N.C.)

  13. Correlation of angina pectoris and perfusion decrease by collateral circulation in single-vessel coronary chronic total occlusion using myocardial perfusion single-photon emssion computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Geon; Park, Ki Seong; Kang, Sae Ryung [Chonnam National University Hospital, Gwangju (Korea, Republic of); and others

    2016-03-15

    To evaluate the perfusion decrease in donor myocardium by collateral circulation and its correlation with angina pectoris in patients with chronic total occlusion (CTO) using myocardial perfusion single-photon emission computed tomography (MPS). Thirty-six patients with single-vessel CTO without any other stenosis were included. All patients underwent MPS and coronary angiography (CAG) within 2 months. Total 72 donor arteries were evaluated for the grades of collaterals to the CTO artery using the Rentrop grading system on CAG. Perfusion defects and perfusion scores in donor and CTO territories were analyzed on MPS. Myocardial perfusion of donor and CTO territories were evaluated according to the presence of angina pectoris and the grades of collateral circulation. When the CTO territory was ischemic, symptomatic patients showed higher summed difference scores in the CTO territory compared to asymptomatic patients (3.5 ± 2.4 vs. 1.5 ± 0.8 for symptomatic and asymptomatic groups respectively; p = 0.034). However, when the CTO territory was nonischemic, symptomatic patients showed higher summed stress scores (SSS, 4.3 ± 2.9 vs. 1.6 ± 1.2; p = 0.032) and summed rest scores (SRS, 4.2 ± 2.5 vs. 1.5 ± 1.1; p = 0.003) in the donor territories. On the per-vessel analysis, perfusion defects in donor territories were more frequent (0 % vs. 53 % vs. 86 % for Rentrop 0, Rentrop 1–2 and Rentrop 3, respectively; p < 0.001) and showed higher SSS (0.0 ± 0.0, 1.3 ± 1.6 and 2.1 ± 1.1 for Rentrop 0, Rentrop 1–2 and Rentrop 3, respectively; p = 0.001) and SRS (0.0 ± 0.0, 1.0 ± 1.4 and 1.7 ± 1.2; p = 0.003) at higher Rentrop grades, but their patterns were variable. Angina pectoris was related to either ischemia of the myocardium beyond CTO or a perfusion decrease in the donor myocardium. The perfusion decrease in donor myocardium positively correlated with the collateral grades.

  14. Acute ischemic cerebral attack

    Directory of Open Access Journals (Sweden)

    Franco-Garcia Samir

    2010-12-01

    Full Text Available The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violent death in the world and the first of disability. Many risk factors favor the presentation of these events and some of them are susceptible of modification and therfore are objetives of primary prevention just as the control of diabetes, hypertension and the practice of healthy habits of life. The advances in the knowledge of the physiopatology, had taken to sustantial change in the nomenclature and management of ischemic ACS. Within these changes it was substituted the term cerebrovascular accident fo acute stroke, making emphasis in the key rol of a timely management with goals of time similiar to the acute coronary syndrome. It was redefined the time of acute ischemic attack to a one hour. Once stablished the cerebrovascular attack the semiology of symtoms with frecuency will led us make a topographic diagnosis of the in injury that joined to the cerebral TAC will allow us to exclude an hemorragic event and to start the treatment. In the management of these patients its essential the coordination of the differents teams of work, from the early recognition of symtoms on the part of patients andthe family, the rapid activation and response of emergency systems and the gearing of health care institutions. Are pillars of treatment: the abcde of reanimatiion, to avoid the hiperpirexis, the seizures, the hipoglicemy, the hiperglicemy, to achieve the thrombolysis in the first three hours of the begining of symtoms, to use antiplatelets, antithrombotic profilaxis

  15. Development of Bioartificial Myocardium Using Stem Cells and Nanobiotechnology Templates

    Directory of Open Access Journals (Sweden)

    Juan Carlos Chachques

    2011-01-01

    Full Text Available Cell-based regenerative therapy is undergoing experimental and clinical trials in cardiology, in order to limit the consequences of decreased contractile function and compliance of damaged ventricles following myocardial infarction. Over 1000 patients have been treated worldwide with cell-based procedures for myocardial regeneration. Cellular cardiomyoplasty seems to reduce the size and fibrosis of infarct scars, limit adverse postischemic remodelling, and improve diastolic function. The development of a bioartificial myocardium is a new challenge; in this approach, tissue-engineered procedures are associated with cell therapy. Organ decellularization for bioscaffolds fabrication is a new investigated concept. Nanomaterials are emerging as the main candidates to ensure the achievement of a proper instructive cellular niche with good drug release/administration properties. Investigating the electrophysiological properties of bioartificial myocardium is the challenging objective of future research, associating a multielectrode network to provide electrical stimulation could improve the coupling of grafted cells and scaffolds with host cardiomyocytes. In summary, until now stem cell transplantation has not achieved clear hemodynamic benefits for myocardial diseases. Supported by relevant scientific background, the development of myocardial tissue engineering may constitute a new avenue and hope for the treatment of myocardial diseases.

  16. Recapitulating maladaptive, multiscale remodeling of failing myocardium on a chip.

    Science.gov (United States)

    McCain, Megan L; Sheehy, Sean P; Grosberg, Anna; Goss, Josue A; Parker, Kevin Kit

    2013-06-11

    The lack of a robust pipeline of medical therapeutic agents for the treatment of heart disease may be partially attributed to the lack of in vitro models that recapitulate the essential structure-function relationships of healthy and diseased myocardium. We designed and built a system to mimic mechanical overload in vitro by applying cyclic stretch to engineered laminar ventricular tissue on a stretchable chip. To test our model, we quantified changes in gene expression, myocyte architecture, calcium handling, and contractile function and compared our results vs. several decades of animal studies and clinical observations. Cyclic stretch activated gene expression profiles characteristic of pathological remodeling, including decreased α- to β-myosin heavy chain ratios, and induced maladaptive changes to myocyte shape and sarcomere alignment. In stretched tissues, calcium transients resembled those reported in failing myocytes and peak systolic stress was significantly reduced. Our results suggest that failing myocardium, as defined genetically, structurally, and functionally, can be replicated in an in vitro microsystem by faithfully recapitulating the structural and mechanical microenvironment of the diseased heart.

  17. PlGF-MMP9-engineered iPS cells supported on a PEG-fibrinogen hydrogel scaffold possess an enhanced capacity to repair damaged myocardium.

    Science.gov (United States)

    Bearzi, C; Gargioli, C; Baci, D; Fortunato, O; Shapira-Schweitzer, K; Kossover, O; Latronico, M V G; Seliktar, D; Condorelli, G; Rizzi, R

    2014-01-01

    Cell-based regenerative therapies are significantly improved by engineering allografts to express factors that increase vascularization and engraftment, such as placental growth factor (PlGF) and matrix metalloproteinase 9 (MMP9). Moreover, the seeding of therapeutic cells onto a suitable scaffold is of utmost importance for tissue regeneration. On these premises, we sought to assess the reparative potential of induced pluripotent stem (iPS) cells bioengineered to secrete PlGF or MMP9 and delivered to infarcted myocardium upon a poly(ethylene glycol)-fibrinogen scaffold. When assessing optimal stiffness of the PEG-fibrinogen (PF) scaffold, we found that the appearance of contracting cells after cardiogenic induction was accelerated on the support designed with an intermediate stiffness. Revascularization and hemodynamic parameters of infarcted mouse heart were significantly improved by injection into the infarct of this optimized PF scaffold seeded with both MiPS (iPS cells engineered to secrete MMP9) and PiPS (iPS cells engineered to secrete PlGF) cells as compared with nonengineered cells or PF alone. Importantly, allograft-derived cells and host myocardium were functionally integrated. Therefore, survival and integration of allografts in the ischemic heart can be significantly improved with the use of therapeutic cells bioengineered to secrete MMP9 and PlGF and encapsulated within an injectable PF hydrogel having an optimized stiffness. PMID:24525729

  18. Chronic non-transmural infarction has a delayed recovery of function following revascularization

    Directory of Open Access Journals (Sweden)

    Palmer John

    2010-01-01

    Full Text Available Abstract Background The time course of regional functional recovery following revascularization with regards to the presence or absence of infarction is poorly known. We studied the effect of the presence of chronic non-transmural infarction on the time course of recovery of myocardial perfusion and function after elective revascularization. Methods Eighteen patients (mean age 69, range 52-84, 17 men prospectively underwent cine magnetic resonance imaging (MRI, delayed contrast enhanced MRI and rest/stress 99m-Tc-tetrofosmin single photon emission computed tomography (SPECT before, one and six months after elective coronary artery bypass grafting (CABG or percutaneous coronary intervention (PCI. Results Dysfunctional myocardial segments (n = 337/864, 39% were classified according to the presence (n = 164 or absence (n = 173 of infarction. Infarct transmurality in dysfunctional segments was largely non-transmural (transmurality = 31 ± 22%. Quantitative stress perfusion and wall thickening increased at one month in dysfunctional segments without infarction (p Conclusions Dysfunctional segments without infarction represent repetitively stunned or hibernating myocardium, and these segments improved both perfusion and function within one month after revascularization with no improvement thereafter. Although dysfunctional segments with non-transmural infarction improved in perfusion at one month, functional recovery was mostly seen between one and six months, possibly reflecting a more severe ischemic burden. These findings may be of value in the clinical assessment of regional functional recovery in the time period after revascularization.

  19. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke.

    Science.gov (United States)

    Arboix, Adrià

    2015-05-16

    Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients. PMID:25984516

  20. [The state of sympathetic-adrenal system in patients with chronic cardiac insufficiency].

    Science.gov (United States)

    Nigmatullin, R R; Kirillova, V V; Dzhordzhikiia, R K; Kudrin, V S; Klodt, P M

    2009-01-01

    Activation of sympato-adrenal system plays an important role in the development of chronic cardiac failure (CCF). However, its relation to morpho-functional state of myocardium in CCF patients is virtually unknown. HPLC with electrochemical detection was used to determine plasma noradrenalin, adrenalin, and their precursors, 3,4-dioxyphenylalanine (DOPA) and dopamine, in patients with different morpho-functional changes in myocardium. The study demonstrated enhanced activity of sympato-adrenal system in patients with CCF. It showed for the first time that activity of sympato-adrenal system in CCF patients depends on the morpho-functional status of myocardium.

  1. Transient Ischemic Attack (Beyond the Basics)

    Science.gov (United States)

    ... and diagnosis (Beyond the Basics)" and "Patient information: Hemorrhagic stroke treatment (Beyond the Basics)" and "Patient information: Ischemic ... symptoms and diagnosis (Beyond the Basics) Patient information: Hemorrhagic stroke treatment (Beyond the Basics) Patient information: Ischemic stroke ...

  2. THE IMPACT OF COMORBIDITY ON COGNITIVE PARAMETERS AFTER ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    Mirena Valkova

    2012-10-01

    Full Text Available Objective: The aim of our study is to examine the impact of comorbidity on cognitive parameters after the first ever ischemic stroke.Material and methods: We examined 112 patients (aged 46 to 84 (66.67± 5.96, 69 males and 43 females with first ever ischemic stroke. For cognitive assessment we used Mini Mental State Examination (MMSE, 10 word test (for short term memory and delayed recall, Isaack’s test for verbal fluency (VF, Geriatric depression scale (GDS, Hamilton depression scale (HDS, Blessed dementia information memory concentration test (revised, BDIMCT, Benton Visual Retention test (A,E; BVRT – number of corrects and number of errors and Wiskonsin Card Sorting Test (number of errors, WCST. The patients were examined on two step model. At acute stage, after collecting medical history, somatic and neurological examinations, MMSE, 10 words test and HDS were applied. At subacute stroke stage (90±5 days after first stroke symptoms, all cognitive tests were used. „STATGRAPHICS Plus 5.0 (free version” was used for statistical analysis.Results: Chronic ischemic heart disease and chronic obstructive pulmonary disease are the most important additional risk factors for cognitive decline. Thyroid pathology, renal failure and anemia are independently associated with poststroke depression.Conclusions: On the basis of these data we can conclude that vascular risk factors are independently associated with cognitive and emotional changes after stroke and their effects should be assessed and taken into account for subsequent treatment of stroke survivors.

  3. MR imaging of ischemic penumbra

    International Nuclear Information System (INIS)

    Cerebral ischemic stroke is one of the most fatal diseases despite current advances in medical science. Recent demonstration of efficacy using intravenous and intra-arterial thrombolysis demands therapeutic intervention tailored to the physiologic state of the individual tissue and stratification of patients according to the potential risks for therapies. In such an era, the role of the neuroimaging becomes increasingly important to evaluate the extent and location of tissues at risk of infarction (ischemic penumbra), to distinguish it from unsalvageable infarcted tissues or doomed hemorrhagic parenchyma. In this review, we present briefly the current role and limitation of computed tomography and conventional magnetic resonance imaging (MRI). We also present the possible applications of advanced MR techniques, such as diffusion and perfusion imaging, concentrating on the delineation or detection of ischemic penumbra

  4. MR imaging of ischemic penumbra

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Osamu E-mail: abediag-tky@umin.ac.jp; Aoki, Shigeki; Shirouzu, Ichiro; Kunimatsu, Akira; Hayashi, Naoto; Masumoto, Tomohiko; Mori, Harushi; Yamada, Haruyasu; Watanabe, Makoto; Masutani, Yoshitaka; Ohtomo, Kuni

    2003-04-01

    Cerebral ischemic stroke is one of the most fatal diseases despite current advances in medical science. Recent demonstration of efficacy using intravenous and intra-arterial thrombolysis demands therapeutic intervention tailored to the physiologic state of the individual tissue and stratification of patients according to the potential risks for therapies. In such an era, the role of the neuroimaging becomes increasingly important to evaluate the extent and location of tissues at risk of infarction (ischemic penumbra), to distinguish it from unsalvageable infarcted tissues or doomed hemorrhagic parenchyma. In this review, we present briefly the current role and limitation of computed tomography and conventional magnetic resonance imaging (MRI). We also present the possible applications of advanced MR techniques, such as diffusion and perfusion imaging, concentrating on the delineation or detection of ischemic penumbra.

  5. Long-term window of ischemic tolerance: An evolutionarily conserved form of metabolic plasticity regulated by epigenetic modifications?

    Science.gov (United States)

    Khoury, Nathalie; Koronowski, Kevin B.; Perez-Pinzon, Miguel A.

    2016-01-01

    In the absence of effective neuroprotective agents in the clinic, ischemic and pharmacological preconditioning are gaining increased interest in the field of cerebral ischemia. Our lab recently reported that resveratrol preconditioning affords tolerance against a focal cerebral ischemic insult in mice that can last for at least 14 days in vivo making it the longest window of ischemic tolerance discovered to date by a single administration of a pharmacological agent. The mechanism behind this novel extended window of ischemic tolerance remains elusive. In the below commentary we discuss potential mechanisms that could explain this novel extended window of ischemic tolerance in the context of previously identified windows and the known mechanisms behind them. We also draw parallels from the fields of hibernation and hypoxia-tolerance, which are chronic adaptations to severe conditions of hypoxia and ischemia known to be mediated by a form of metabolic depression. We also briefly discuss the importance of epigenetic modifications in maintaining this depressed state of metabolism.

  6. Technetium-99m sestamibi kinetics in reperfused canine myocardium

    International Nuclear Information System (INIS)

    The purpose of the current study was to clarify the myocardial kinetics of technetium-99m sestamibi when the latter is administered during reperfusion. Sestamibi has in the past been given to patients following thrombolytic therapy to document reperfusion and assess salvage. However, the factors which affect sestamibi kinetics during reperfusion are not clearly defined. In this study the left circumflex coronary artery was occluded for 2 h in six dogs (group 1) and for 3 h in six dogs (group 2), followed by reperfusion. Five additional dogs were not reperfused (group 3). Sestamibi was administered during reperfusion in groups 1 and 2, and during ongoing occlusion in group 3. Regional myocardial sestamibi activity was monitored for 3 h using miniature implanted radiation detectors and gamma camera imaging. Group 1 dogs had no infarcts, group 2 had moderate infarcts (mean: 13.9%), and group 3 had large infarcts (mean: 25.2%). Three-hour fractional myocardial clearances were significantly greater for reperfused infarcted (group 2) (0.23±0.02 SEM) and for nonreperfused infarcted myocardium (group 3) (0.24±0.02) compared to control (0.10±0.01) and reperfused noninfarcted myocardium (group 1) (0.07±0.02; P<0.01). Quantitative image analysis demonstrated a significant reduction in the left circumflex/left anterior descending count ratios from initial to final scans for group 2 (0.74±0.03 to 0.65±0.03, P<0.05), and a trend towards a reduction in the count ratios from initial to final scans for group 3 (0.38±0.04 to 0.30±0.04; P=0.06). Thus, probederived myocardial sestamibi kinetics following reperfusion do differentiate non-infarcted from infarcted myocardium. Although the detection of accelerated clearance can be demonstrated by quantitative analysis of gamma camera images in dogs, this may be technically difficult in clinical situations. (orig.)

  7. Myocardial uptake of Tc-99m MDP in chronic renal failure with cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Eun; Sohn, Hyung Sun; Chung, Yong An; Park, Young Ha; Kim, Sung Hoon; Chung, Soo Kyo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2000-06-01

    A uremic patient on hemodialysis, who had concurrent cardiomyopathy showed intense myocardial uptake of {sup 99m}Tc-methylene diphosphonate (MDP). The presumed cause of uptake in the myocardium is metastatic calcification due to hypercalcemia secondary to the renal failure. However, supplementary mechanism caused by cardiomyopathy should be considered. We describe a case with bone tracer uptake in the myocardium in the absence of infarction in a patient with chronic renal failure.

  8. Mutation in lamin A/C sensitizes the myocardium to exercise-induced mechanical stress but has no effect on skeletal muscles in mouse.

    Science.gov (United States)

    Cattin, Marie-Elodie; Ferry, Arnaud; Vignaud, Alban; Mougenot, Nathalie; Jacquet, Adeline; Wahbi, Karim; Bertrand, Anne T; Bonne, Gisèle

    2016-08-01

    LMNA gene encodes lamin A/C, ubiquitous proteins of the nuclear envelope. They play crucial role in maintaining nuclear shape and stiffness. When mutated, they essentially lead to dilated cardiomyopathy with conduction defects, associated or not with muscular diseases. Excessive mechanical stress sensitivity has been involved in the pathophysiology. We have previously reported the phenotype of Lmna(delK32) mice, reproducing a mutation found in LMNA-related congenital muscular dystrophy patients. Heterozygous Lmna(delK32/+) (Het) mice develop a progressive dilated cardiomyopathy leading to death between 35 and 70 weeks of age. To investigate the sensitivity of the skeletal muscles and myocardium to chronic exercise-induced stress, Het and wild-type (Wt) mice were subjected to strenuous running treadmill exercise for 5 weeks. Before exercise, the cardiac function of Het mice was similar to Wt-littermates. After the exercise-period, Het mice showed cardiac dysfunction and dilation without visible changes in cardiac morphology, molecular remodelling or nuclear structure compared to Wt exercised and Het sedentary mice. Contrary to myocardium, skeletal muscle ex vivo contractile function remained unaffected in Het exercised mice. In conclusion, the expression of the Lmna(delK32) mutation increased the susceptibility of the myocardium to cardiac stress and led to an earlier onset of the cardiac phenotype in Het mice. PMID:27287550

  9. [Pregnancy and acute ischemic stroke].

    Science.gov (United States)

    Bereczki, Dániel

    2016-05-15

    Pregnancy-related ischemic strokes play an important role in both maternal and fetal morbidity and mortality. Changes in hemostaseology and hemodynamics as well as risk factors related to or independent from pregnancy contribute to the increased stroke-risk during gestation and the puerperium. Potential teratogenic effects make diagnostics, acute therapy and prevention challenging. Because randomized, controlled trials are not available, a multicenter registry of patients with gestational stroke would be desirable. Until definite guidelines emerge, management of acute ischemic stroke during pregnancy remains individual, involving experts and weighing the risks and benefits.

  10. Salvia miltiorrhiza and ischemic diseases

    Institute of Scientific and Technical Information of China (English)

    Xin-Yan JI; Benny K-H TAN; Yi-Zhun ZHU

    2000-01-01

    The demonstration of beneficial effects of salvia miltiorrhiza (DanShen) on ischemic diseases has revolutionized the management of angina pectoris, myocardial infarction (MI) or stroke in Chinese society. Experimental studies have shown that DanShen dilated coronary arteries, increased coronary blood flow, and scavenged free radicals in ischemic diseases, so that it reduced the cellular damage from ischemia and improved heart functions. Clinical trials also indicated that DanShen was an effective medicine for angina pectoris, MI, and stroke. This review will focus on DanShen's effects in angina pectoris, MI and stroke.

  11. Pathomorphological Changes of the Myocardium in Canine Dilated Cardiomyopathy (DCM

    Directory of Open Access Journals (Sweden)

    Janus Izabela

    2015-04-01

    Full Text Available The study was conducted on ventricular and atrial wall preparations from 11 dogs with clinically diagnosed dilated cardiomyopathy. After fixation, the specimens were stained with haematoxylin and eosin and Masson-Goldner trichrome technique. Parenchymal changes (fibrosis and fatty infiltration, vascular changes (congestion and coronary vessel wall hypertrophy, degenerative changes (loss of striation, changes in cardiomycyte and nuclei structure, and presence of inflammatory infiltrates (mononuclear and polynuclear were estimated. Complex histological changes in both ventricular and atrial muscles were shown. It was not determined whether the processes occurring in the myocardium have a primary character, or are a consequence of developing heart failure. Such issues will be put under further and more detailed examination.

  12. AKT-modified autologous intracoronary mesenchymal stem cells prevent remodeling and repair in swine infarcted myocardium

    Institute of Scientific and Technical Information of China (English)

    YU Yun-sheng; SHEN Zhen-ya; YE Wen-xue; HUANG Hao-yue; HUA Fei; CHEN Yi-huan; CHEN Ke; LAO Wei-jie; TAO Li

    2010-01-01

    Background Transplantation of adult bone marrow-derived mesenchymal stem cells (MSCs) has been proposed as a strategy for cardiac repair following myocardial damage. However cell transplantation strategies to replace lost myocardium are limited by the inability to deliver large numbers of cells that resist peritransplantation graft cell death. Accordingly, we set out to isolate and expand adult swine bone marrow-derived MSCs, and to engineer these cells to overexpress AKT1 (protein kinase B), to test the hypothesis that AKT1 -engineered MSCs are more resistant to apoptosis and can enhance cardiac repair after transplantation into the ischemic swine heart.Methods The CDS (regulation domain of AKT1) AKT1-cDNA fragment was amplified, and MSCs were transfected following synthesis with a pCDH1-AKT1 shuttling plasmid. Western blotting analysis and real-time reverse transcription-polymerase chain reaction (RT-PCR) was performed. Myocardial infarction (Ml) models were constructed in Meishan pigs, and cardiac function was evaluated by magnetic resonance imaging (MRI) measurements and echocardiography 4 weeks later. All pigs were assigned to four groups: control (A), DMEM (B), MSC (C), and AKT-transfected (D). MSCs were transfected with the AKT1 gene, and autologous BrdU-labeled stem cells (1 × 107/5 ml) were injected into left anterior descending coronary atery (LAD) of the infarct heart in groups C and D. In group B, DMEM was injected using the same approach. In group A, there was no injection following LAD occlusion. After 4 weeks, cardiac function and regional perfusion measurements were repeated by MRI and echocardiography, and histological characteristics of the hearts were assessed. Connecxin-43 (CX-43), BrdU, and von Willebrand factor (VWF) immunoreactivity was tested using enzyme linked immunosorbent assay (ELISA). Vascular endothelial growth factor (VEGF), transforming growth factor-(31 (TGF-p1) were analyzed at the same time.Results AKT1-cDNA was cloned into p

  13. Repair of swine infarcted myocardium with 5-azacytidine intramyocardial injection

    International Nuclear Information System (INIS)

    Objective: To study swine infarcted myocardium repairment after 5-azacytidine intramyocardial injection. Methods: Twenty young swines were divided into the treatment and control group randomly. The acute myocardial infarction (AMI)models were made by ligating the left anterior descending (LAD) as previously described. After 3 weeks, 1 ml 5-azacytidine in 1 mg/ml concentration was intramyocardium injected into infarcted and border regions in the treatment group (n=10). In the control group (n=10), the same volume of cell culture medium was injected into infarcted myocardial tissue through intramyocardium. Positron emission tomography (PET) was examined at 3rd weeks and 7th weeks. After 7 weeks, the animals were killed, the specimens were harvested for triphenyltetrazolium chloride (TTC) and HE staining, electron microscopical studies and immunohistochemical examination for β muscle heavy chain (β-MHC), cardiac troponin I (cTn I) and connexin43 (Cx43). Results: PET demonstrated that radioactivity in the left ventricular free wall and apex became thick in the animals in the treatment group at 7th week compared with the animals in the control group. The infarcted area stained with TTC method and its percentage had significant difference between the treatment and the control group[(4.06 ± 0.29) cm2 vs (5.41 ± 0.28) cm2; (16.34 ± 0.89)% vs(21.23 ± 1.02)%, P<0.001]. New island and striated muscles were found in the treatment group at the site of injection. Actin were filaments with transmission electron microscopy found but not intercalated discs in the new muscle cells; these cells were positive with cellular immunohistochemical stain on β-MHC, cTnI and Cx43. There were symmetrical fibrous scar tissue with negative immunohistochemical result in the infarcted area in the control group. Conclusion: 5-azacytidine intramyocardial injection could repair swine myocardium injury. (authors)

  14. Cardiac magnetic resonance T1 mapping of left atrial myocardium

    Science.gov (United States)

    Beinart, Roy; Khurram, Irfan M.; Liu, Songtao; Yarmohammadi, Hirad; Halperin, Henry R.; Bluemke, David A.; Gai, Neville; van der Geest, Rob J.; Lima, Joao A.C.; Calkins, Hugh; Zimmerman, Stefan L.; Nazarian, Saman

    2013-01-01

    BACKGROUND Cardiac magnetic resonance (CMR) T1 mapping is an emerging tool for objective quantification of myocardial fibrosis. OBJECTIVES To (a) establish the feasibility of left atrial (LA) T1 measurements, (b) determine the range of LA T1 values in patients with atrial fibrillation (AF) vs healthy volunteers, and (c) validate T1 mapping vs LA intracardiac electrogram voltage amplitude measures. METHODS CMR imaging at 1.5 T was performed in 51 consecutive patients before AF ablation and in 16 healthy volunteers. T1 measurements were obtained from the posterior LA myocardium by using the modified Look-Locker inversion-recovery sequence. Given the established association of reduced electrogram amplitude with fibrosis, intracardiac point-by-point bipolar LA voltage measures were recorded for the validation of T1 measurements. RESULTS The median LA T1 relaxation time was shorter in patients with AF (387 [interquartile range 364–428] ms) compared to healthy volunteers (459 [interquartile range 418–532] ms; P < .001) and was shorter in patients with AF with prior ablation compared to patients without prior ablation (P = .035). In a generalized estimating equations model, adjusting for data clusters per participant, age, rhythm during CMR, prior ablation, AF type, hypertension, and diabetes, each 100-ms increase in T1 relaxation time was associated with 0.1 mV increase in intracardiac bipolar LA voltage (P = .025). CONCLUSIONS Measurement of the LA myocardium T1 relaxation time is feasible and strongly associated with invasive voltage measures. This methodology may improve the quantification of fibrotic changes in thin-walled myocardial tissues. PMID:23643513

  15. Compromised Wound Healing in Ischemic Type 2 Diabetic Rats.

    Directory of Open Access Journals (Sweden)

    Peilang Yang

    Full Text Available Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8 weeks high fat diet (HFD feeding regimen followed by multiple injections of streptozotocin (STZ at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds.

  16. Compromised Wound Healing in Ischemic Type 2 Diabetic Rats.

    Science.gov (United States)

    Yang, Peilang; Pei, Qing; Yu, Tianyi; Chang, Qingxuan; Wang, Di; Gao, Min; Zhang, Xiong; Liu, Yan

    2016-01-01

    Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8 weeks high fat diet (HFD) feeding regimen followed by multiple injections of streptozotocin (STZ) at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds. PMID:27028201

  17. Ischemic stroke and incomplete infarction

    DEFF Research Database (Denmark)

    Garcia, Javier; Lassen, N A; Weiller, C;

    1996-01-01

    The concept of selective vulnerability or selective loss o f individual neurons, with survival of glial and vascular elements as one of the consequences of a systemic ischemic-hypoxic insult (eg, transient cardiac arrest or severe hypotension), has been recognized for decades. In contrast, select...

  18. Monocytes in ischemic heart disease

    NARCIS (Netherlands)

    A.M. van der Laan

    2013-01-01

    The link between the immune system and ischemic heart disease has been recognized for years and great improvements have been made in understanding the role of immune cells in the context of infarct healing, atherosclerosis and arteriogenesis, using experimental and in vitro models. However, the role

  19. Let's Talk about Ischemic Stroke

    Science.gov (United States)

    ... Tools & Resources Stroke More Let's Talk About Ischemic Stroke Updated:Dec 9,2015 The majority of strokes occur when blood vessels to the brain become ... cuts off blood flow to brain cells. A stroke caused by lack of blood reaching part of ...

  20. Neuroprotection in acute ischemic stroke

    NARCIS (Netherlands)

    De Keyser, Jacques; Uyttenboogaart, Maarten; Koch, Marcus W; Elting, Jan Willem; Sulter, Geert; Vroomen, Patrick C; Luijckx, Gert Jan

    2005-01-01

    Neuroprotection of patients with acute ischemic stroke should start at the scene and continue in the ambulance with the assessment and treatment of the airway, breathing, circulation, body temperature, and blood glucose. The key goal in eligible patients should be fast vessel recanalization with int

  1. Ischemic glans penis after circumcision

    Institute of Scientific and Technical Information of China (English)

    Yuan-ShengTzeng; Shou-HungTang; EnMeng; Teng-FuLin; Guang-HuanSun

    2004-01-01

    A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.

  2. Sex Hormones and Ischemic Stroke

    DEFF Research Database (Denmark)

    Holmegard, Haya N; Nordestgaard, Børge G; Jensen, Gorm B;

    2016-01-01

    CONTEXT AND OBJECTIVE: Whether endogenous sex hormones are associated with ischemic stroke (IS) is unclear. We tested the hypothesis that extreme concentrations of endogenous sex hormones are associated with risk of IS in the general population. DESIGN, SETTING, AND PARTICIPANTS: Adult men (n...

  3. The alteration of interelemental ratios in myocardium under the congenital heart disease (SRXRF)

    Science.gov (United States)

    Trunova, V. A.; Zvereva, V. V.; Okuneva, G. N.; Levicheva, E. N.

    2007-05-01

    It is the myocardium that bears the basic functional loading during heart working, including muscle contractility and enzyme activity. The elemental concentrations in myocardium tissue of heart were determined by SRXRF technique. Our investigation is systematical: the elemental content in each compartment (left and right ventricles, left and right auricles) of hearts of healthy and diseased children (congenital heart diseases, transposition of main vessels (TMV)) was analyzed. The elemental distribution in myocardium of four heart chambers of human fetuses was also analyzed. Following elements were determined: S, Cl, K, Ca, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Br, Rb, Sr. It was revealed that the elemental concentrations in myocardium of both ventricles are almost constant in heart of fetuses and healthy children. The transition from pre-natal study (fetus) to post-natal study is accompanied by the redistribution of chemical elements in myocardium. The higher concentrations of S, Fe, Ca, Sr and Cu in myocardium of children are observed, the content of K, Br, Rb and especially Se is lower than in heart of fetuses. The elemental distribution in myocardium of children TMV is considerably different in comparison with the healthy children: the higher levels of Cu are observed. The content of Se is lower.

  4. Chronic aseptic meningitis in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Lancman, M E; Mesropian, H; Granillo, R J

    1989-08-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus. It may occur early in the course of the disease and sometimes may be the initial symptom. We report a patient with chronic aseptic meningitis associated with systemic lupus erythematosus. Magnetic resonance imaging showed several ischemic lesions and an appearance which was compatible with chronic inflammation of the ependyma of the lateral ventricles.

  5. Trends in Mortality from Ischemic Heart Disease, Stroke, and Stomach Cancer: from past to future

    NARCIS (Netherlands)

    M. Amiri (Masoud)

    2010-01-01

    textabstractThe common occurrence of chronic diseases – such as ischemic heart diseases (IHD, stroke, and stomach cancer in most populations and the attendant mortality, loss of independence, impaired quality of life, and social and economic costs are compelling reasons for public health concern. A

  6. Cardiac function improved by sarcoplasmic reticulum Ca2+-ATPase overexpression in a heart failure model induced by chronic myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Wei XIN

    2011-04-01

    Full Text Available Objective Chronic myocardial ischemia(CMI has become an important cause of heart failure(HF.The aim of present study was to examine the effects of Sarco-endoplasmic reticulum calcium ATPase(SERCA2a gene transfer in HF model in large animal induced by CMI.Methods HF was reproduced in minipigs by ligating the initial segment of proximal left anterior descending(LAD coronary artery with an ameroid constrictor to produce progressive vessel occlusion and ischemia.After confirmation of myocardial perfusion defect and cardiac function impairment by SPECT and echocardiography in the model,animals were divided into 4 groups: HF group;HF+enhanced green fluorescent protein(EGFP group;HF+SERCA2a group;and sham operation group as control.rAAV1-EGFP and rAAV1-SERCA2a(1×1012 vg for each animal were directly and intramyocardially injected to the animals of HF+EGFP and HF+SERCA2a groups.Sixty days after the gene transfer,the expression of SERCA2a at the protein level was examined by Western blotting and immunohistochemistry,the changes in cardiac function were determined by echocardiographic and hemodynamic analysis,and the changes in serum inflammatory and neuro-hormonal factors(including BNP,TNF-a,IL-6,ET-1 and Ang II were determined by radioimmunoassay.Results Sixty days after gene transfer,LVEF,Ev/Av and ±dp/dtmax increased significantly(P < 0.05,along with an increase of SERCA2a protein expression in the ischemic myocardium(PP < 0.05,accompanied by a significant decrease of inflammatory and neural-hormonal factors(PP < 0.05 in HF+SERCA2a group as compared with HF/HF+EGFP group.Conclusions Overexpression of SERCA2a may significantly improve the cardiac function of the ischemic myocardium of HF model induced by CMI and reverse the activation of neural-hormonal factors,implying that it has a potential therapeutic significance in CMI related heart failure.

  7. Magnetic resonance imaging and multi-detector computed tomography assessment of extracellular compartment in ischemic and non-ischemic myocardial pathologies

    Institute of Scientific and Technical Information of China (English)

    Maythem; Saeed; Steven; W; Hetts; Robert; Jablonowski; Mark; W; Wilson

    2014-01-01

    Myocardial pathologies are major causes of morbidity and mortality worldwide. Early detection of loss of cellular integrity and expansion in extracellular volume(ECV) in myocardium is critical to initiate effective treatment. The three compartments in healthy myocardium are: intravascular(approximately 10% of tissue volume), interstitium(approximately 15%) and intracellular(approximately 75%). Myocardial cells, fibroblasts and vascular endothelial/smooth muscle cells represent intracellular compartment and the main proteins in the interstitium are types Ⅰ/Ⅲ collagens. Microscopic studies have shown that expansion of ECV is an important feature of diffuse physiologic fibrosis(e.g., aging and obesity) and pathologic fibrosis [heart failure, aortic valve disease, hypertrophic cardiomyopathy, myocarditis, dilated cardiomyopathy, amyloidosis, congenital heart disease, aortic stenosis, restrictive cardiomyopathy(hypereosinophilic and idiopathic types), arrythmogenic right ventricular dysplasia and hypertension]. This review addresses recent advances in measuring of ECV in ischemic and non-ischemic myocardial pathologies. Magnetic resonance imaging(MRI) has the ability to characterize tissue proton relaxation times(T1, T2, and T2*). Proton relaxation times reflect the physical and chemical environments of water protons in myocardium. Delayed contrast enhanced-MRI(DE-MRI) and multi-detector computed tomography(DE-MDCT) demonstrated hyper-enhanced infarct, hypo-enhanced microvascular obstruction zone and moderately enhanced peri-infarct zone, but are limited for visualizing diffuse fibrosis and patchy microinfarct despite the increase in ECV. ECV can be measured on equilibrium contrast enhanced MRI/MDCT and MRI longitudinal relaxation time mapping. Equilibrium contrast enhanced MRI/MDCT and MRI T1 mapping is currently used, but at a lower scale, as an alternative to invasive sub-endomyocardial biopsies to eliminate the need for anesthesia, coronary catheterization and

  8. Mortality by Heart Failure and Ischemic Heart Disease in Brazil from 1996 to 2011

    Energy Technology Data Exchange (ETDEWEB)

    Gaui, Eduardo Nagib, E-mail: engaui@cardiol.br; Oliveira, Gláucia Maria Moraes de [Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Klein, Carlos Henrique [Escola Nacional de Saúde Pública Sérgio Arouca da Fundação Oswaldo Cruz, Rio de Janeiro, RJ (Brazil)

    2014-06-15

    Circulatory system diseases are the first cause of death in Brazil. To analyze the evolution of mortality caused by heart failure, by ischemic heart diseases and by ill-defined causes, as well as their possible relations, in Brazil and in the geoeconomic regions of the country (North, Northeast, Center-West, South and Southeast), from 1996 to 2011. Data were obtained from DATASUS and death declaration records with codes I20 and I24 for acute ischemic diseases, I25 for chronic ischemic diseases, and I50 for heart failure, and codes in chapter XIII for ill-defined causes, according to geoeconomic regions of Brazil, from 1996 to 2011. Mortality rates due to heart failure declined in Brazil and its regions, except for the North and the Northeast. Mortality rates due to acute ischemic heart diseases increased in the North and Northeast regions, especially from 2005 on; they remained stable in the Center-West region; and decreased in the South and in the Southeast. Mortality due to chronic ischemic heart diseases decreased in Brazil and in the Center-West, South and Southeast regions, and had little variation in the North and in the Northeast. The highest mortality rates due to ill-defined causes occurred in the Northeast until 2005. Mortality due to heart failure is decreasing in Brazil and in all of its geoeconomic regions. The temporal evolution of mortality caused by ischemic heart diseases was similar to that of heart failure. The decreasing number of deaths due to ill-defined causes may represent the improvement in the quality of information about mortality in Brazil. The evolution of acute ischemic heart diseases ranged according to regions, being possibly confused with the differential evolution of ill-defined causes.

  9. Role of platelet-rich plasma in ischemic heart disease: An update on the latest evidence

    Institute of Scientific and Technical Information of China (English)

    Eleftherios; Spartalis; Periklis; Tomos; Demetrios; Moris; Antonios; Athanasiou; Charalampos; Markakis; Michael; D; Spartalis; Theodore; Troupis; Dimitrios; Dimitroulis; Despina; Perrea

    2015-01-01

    Myocardial infarction is the most common cause of congestive heart failure. Novel strategies such as directly reprogramming cardiac fibroblasts into cardiomyocytes are an exciting area of investigation for repair of injured myocardial tissue. The ultimate goal is to rebuild functional myocardium by transplanting exogenous stem cells or by activating native stem cells to induce endogenous repair. Cell-based myocardial restoration, however, has not penetrated broad clinical practice yet. Plateletrich plasma, an autologous fractionation of whole blood containing high concentrations of growth factors, has been shown to safely and effectively enhance healing and angiogenesis primarily by reparative cell signaling. In this review, we collected all recent advances in novel therapies as well as experimental evidence demonstrating the role of platelet-rich plasma in ischemic heart disease, focusing on aspects that might be important for future successful clinical application.

  10. Roles of Chinese herbal medicines in ischemic heart diseases (IHD) by regulating oxidative stress.

    Science.gov (United States)

    Wang, Dawei; Wang, Jin; Liu, Yuntao; Zhao, Zhen; Liu, Qing

    2016-10-01

    Ischemic heart disease (IHD) basing on atherosclerosis (AS) is known as a top killer for decades. Oxidative stress, representing excessive oxidation and insufficient elimination, has been proved to be a critical molecular mechanism of IHD and accompanying myocardium dysfunction. Therefore, anti-oxidation therapy may be efficient. Chinese herbal medicine, including extractive compounds, decoctions, patent drugs, and injections, has shown its enormous potential in prevention and treatment of IHD as an effective antioxidant in experimental studies. The aim of this review is to highlight recent studies of Chinese herbal medicine in regulating oxidative stress in IHD. These studies represent recent progress of IHD treatment and indicate the possible pathways and target spots of Chinese herbal medicine. PMID:27390948

  11. Pharmacokinetics of ligustrazine ethosome patch in rats and anti-myocardial ischemia and anti-ischemic reperfusion injury effect

    Directory of Open Access Journals (Sweden)

    Liu X

    2011-07-01

    Full Text Available Xingyan Liu1, Hong Liu1, Zhaowu Zeng2, Weihua Zhou3, Jianqiang Liu2, Zhiwei He11China-America Cancer Research Institute, Guangdong Medical College, 2Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical College, Dongguan, Guangdong, 3Yichun University, Yichun, Jiangxi, People's Republic of ChinaAbstract: The objective of this study was to investigate the pharmacokinetics of the ligustrazine ethosome patch and antimyocardial ischemia and anti-ischemic reperfusion injury effect. Male Sprague Dawley rats were divided randomly into 3 groups: Group A (intragastric ligustrazine, Group B (transdermal ligustrazine ethosome patch, and Group C (conventional transdermal ligustrazine patch. After treatment, samples of blood and of various tissues such as heart, liver, spleen, lung, kidney, brain, and muscle samples were taken at different time points. Drug concentration was measured with HPLC, and the drug concentration–time curve was plotted. Pharmacokinetic software 3p97 was applied to calculate pharmacokinetic parameters and the area under the drug concentration–time curve (AUC in various tissues. The rat model of acute myocardial ischemia was constructed with intravenous injection of pituitrin and the model of myocardial ischemia-perfusion injury was constructed by tying off the left anterior descending coronary artery of rats to observe the effect of ligustrazine ethosome patches on ischemic myocardium and ischemia-reperfusion injury. Results showed that AUC was highest in the transdermal drug delivery group of ligustrazine ethosome patch. There were significant differences in whole blood viscosity, plasma viscosity, hematocrit, red blood cell aggregation index, and deformation index between ligustrazine the ethosome patch group and ischemic control group (P < 0.01. Moreover, ligustrazine ethosome patches could reduce the scope of myocardial infarction induced by long-term ischemia. Ligustrazine ethosome patches

  12. Left ventricular dysfunction in ischemic heart disease: fundamental importance of the fibrous matrix.

    Science.gov (United States)

    Swan, H J

    1994-05-01

    The contractile function of the myocardium is coordinated by a fibrous matrix of exquisite organization and complexity. In the normal heart, and apparently in physiological hypertrophy, this matrix is submicroscopic. In pathological states changes are frequent, and usually progressive. Thickening of the many elements of the fine structure is due to an increased synthesis of Type I collagen, This change, which affects the myocardium in a global manner, can be observed by light microscopy using special techniques. Perivascular fibrosis, with an increase in vascular smooth muscle, is accompanied by development of fibrous septa, with a decrease in diastolic compliance. These structural changes are believed to be due to increased activation of the renin-angiotensin-aldosterone system, and to be independent of the processes of myocyte hypertrophy. Reparative or replacement fibrosis is a separate process by means of which small and large areas of necrosis heal, with the development of coarse collagen structures, which lack a specific organizational pattern. Regarding ischemic heart disease, an increase in tissue collagenase is found in experimental myocardial "stunning" and in the very early phase of acute infarction. Absence of elements of the fibrous matrix allow for myocyte slippage, and--if the affected area is large--cardiac dilatation. If, subsequently, the necrosis becomes transmural, there is further disturbance of collagen due to both mechanical strain and continued autolysis, During healing collagen synthesis increases greatly to allow for reparative scarring in the available tissue matrix. In cases of infarction with moderate or severe initial dilatation, pathological hypertrophy of the spared myocardium is progressive, accounting for late heart failure and poor survival.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Effects of Endotoxaemia on Protein Metabolism in Rat Fast-Twitch Skeletal Muscle and Myocardium

    OpenAIRE

    Andrew J Murton; Nima Alamdari; Gardiner, Sheila M.; Dumitru Constantin-Teodosiu; Robert Layfield; Terence Bennett; Greenhaff, Paul L.

    2009-01-01

    BACKGROUND: It is unclear if the rat myocardium undergoes the same rapid reductions in protein content that are classically observed in fast-twitch skeletal muscle during endotoxaemia. METHODOLOGY/PRINCIPAL FINDINGS: To investigate this further, and to determine if there is any divergence in the response of skeletal muscle and myocardium in the mechanisms that are thought to be largely responsible for eliciting changes in protein content, Sprague Dawley rats were implanted with vascular cathe...

  14. Features Of Daily Dynamics Of Catecholamine Level In Myocardium Under The Influence Of Low Alcohol Drinks

    OpenAIRE

    O.I. Kostin; T.I. Dzhandarova; Т.В. Kostina

    2009-01-01

    The research goal was to study the features of daily dynamics of adrenaline and noradrenaline content in various parts of myocardium at the rats receiving nonalcoholic and alcohol-containing beer at ordinary light regimen. Substantial increase of level of adrenaline and noradrenaline in all parts of myocardium at the rats received nonalcoholic and spirit-based beer in comparison with the control. At the rats received nonalcoholic beer, authentically higher content of adrenaline and low noradr...

  15. Relationship Between Renin-Angiotensin System Gene Polymorphism and Ischemic Chronic Heart Failure in Aged Coronary Artery Disease Patient%肾素-血管紧张素系统双基因多态性与老年人冠心病慢性心力衰竭的关系

    Institute of Scientific and Technical Information of China (English)

    彭健; 罗礼云; 李铁; 梅啸; 牛云茜; 龚五星

    2011-01-01

    Objective :To investigate the relationship between angiotensin-converting enzyme (ACE)gene insertion/deletion (l/D) and angiotensinogen (AGT) gene M235T polymorphism with the onset of ischemic chronic heart failure (CHF) in aged coronary artery disease (CAD) patients in South China.Methods: A total of 396 consecutive CAD patients with the age of (60 ~ 91 ) years were divided into two groups, CHF group,n = 196 ,and Control group,n = 200 ,the patients had stable angina pectoris and with the left ventricular ejection fraction ≥ 45%.Genotype distributions, ACE gene I/D and AGT gene M235T polymorphisms were analyzed by PCR and restriction fragment length polymorphism (RFLP) methods in both groups.Results:①The frequencies of DD genotype of ACE gene and D allele of ACE gene were higher in CHF group than that in Control group respectively. ②The frequencies of TI genotype and T allele of AGT gene were higher in CHF group than that in Control group. ③In combined genotype analysis,the genotype of DD in ACE + TI in AGT was significantly higher in CHF group than that in Control group (28. 6% vs. 15.0% ).Conclusion: ACE gene I/D polymorphism and AGT gene M235T polymorphisms are related to the onset of ischemic chronic heart failure in aged CAD patients in South China,ACE and AGT gene have an interaction role in the onset of CHF.%目的:探讨中国南方部分汉族人群的老年冠心病患者中,肾素-血管紧张素系统中的关键成分即血管紧张素转换酶(ACE)及血管紧张素原(AGT)双基因多态性与慢性心力衰竭(心衰)发病的关系.方法:应用聚合酶链反应及限制性片断长度多态性技术,对396例老年冠心病患者的ACE基因插入/缺失(I/D)及AGT基因M235T多态性进行检测.将其中196例合并慢性心衰患者作为病例组,其余200例心功能正常者作为对照组.结果:①病例组DD基因型频率及D等位基因频率均高于对照组;②病例组TT基因型频率及T等位基因频率均高

  16. Perinatal Hypoxic-Ischemic Encephalopathy

    OpenAIRE

    Ming-Chi Lai; San-Nan Yang

    2011-01-01

    Perinatal hypoxic-ischemic encephalopathy (HIE) is an important cause of brain injury in the newborn and can result in long-term devastating consequences. Perinatal hypoxia is a vital cause of long-term neurologic complications varying from mild behavioural deficits to severe seizure, mental retardation, and/or cerebral palsy in the newborn. In the mammalian developing brain, ongoing research into pathophysiological mechanism of neuronal injury and therapeutic strategy after perinatal hypoxia...

  17. SERCA overexpression reduces hydroxyl radical injury in murine myocardium.

    Science.gov (United States)

    Hiranandani, Nitisha; Bupha-Intr, Tepmanas; Janssen, Paul M L

    2006-12-01

    Hydroxyl radicals (*OH) are involved in the pathogenesis of ischemia-reperfusion injury and are observed in clinical situations, including acute heart failure, stroke, and myocardial infarction. Acute transient exposure to *OH causes an intracellular Ca(2+) overload and leads to impaired contractility. We investigated whether upregulation of sarcoplasmic reticulum Ca(2+)-ATPase function (SERCA) can attenuate *OH-induced dysfunction. Small, contracting right ventricular papillary muscles from wild-type (WT) SERCA1a-overexpressing (transgenic, TG) and SERCA2a heterogeneous knockout (HET) mice were directly exposed to *OH. This brief 2-min exposure led to a transient elevation of diastolic force (F(dia)) and depression of developed force (F(dev)). In WT mice, F(dia) increased to 485 +/- 49% and F(dev) decreased to 11 +/- 3%. In sharp contrast, in TG mice F(dia) increased only to 241 +/- 17%, whereas F(dev) decreased only to 51 +/- 5% (P group. The results indicate that SERCA overexpression can reduce the *OH-induced contractile dysfunction in murine myocardium, whereas a reduced SR Ca(2+)-ATPase activity aggravates this injury. Loss of pPLB levels at Ser16 likely amplifies the differences observed in injury response.

  18. Probing myocardium biomechanics using quantitative optical coherence elastography

    Science.gov (United States)

    Wang, Shang; Lopez, Andrew L.; Morikawa, Yuka; Tao, Ge; Li, Jiasong; Larina, Irina V.; Martin, James F.; Larin, Kirill V.

    2015-03-01

    We present a quantitative optical coherence elastographic method for noncontact assessment of the myocardium elasticity. The method is based on shear wave imaging optical coherence tomography (SWI-OCT), where a focused air-puff system is used to induce localized tissue deformation through a low-pressure short-duration air stream and a phase-sensitive OCT system is utilized to monitor the propagation of the induced tissue displacement with nanoscale sensitivity. The 1-D scanning of M-mode OCT imaging and the application of optical phase retrieval and mapping techniques enable the reconstruction and visualization of 2-D depth-resolved shear wave propagation in tissue with ultra-high frame rate. The feasibility of this method in quantitative elasticity measurement is demonstrated on tissue-mimicking phantoms with the estimated Young's modulus compared with uniaxial compression tests. We also performed pilot experiments on ex vivo mouse cardiac muscle tissues with normal and genetically altered cardiomyocytes. Our results indicate this noncontact quantitative optical coherence elastographic method can be a useful tool for the cardiac muscle research and studies.

  19. Robust left ventricular myocardium segmentation for multi-protocol MR

    Science.gov (United States)

    Groth, A.; Weese, J.; Lehmann, H.

    2012-02-01

    For a number of cardiac procedures like the treatments of ventricular tachycardia (VT), coronary artery disease (CAD) and heart failure (HF) both anatomical as well as vitality information about the left ventricular myocardium are required. To this end, two images for the anatomical and functional information, respectively, must be acquired and analyzed, e.g. using two different 3D MR protocols. To enable automatic analysis, a workflow has been proposed1 which allows to integrate the vitality information extracted from the functional image data into a patient-specific anatomical model generated from the anatomical image. However, in the proposed workflow the extraction of accurate vitality information from the functional image depends to a large extend on the accuracy of both the anatomical model and the mapping of the model to the functional image. In this paper we propose and evaluate methods for improving these two aspects. More specifically, on one hand we aim to improve the segmentation of the often low-contrast left ventricular epicardium in the anatomical 3D MR images by introducing a patient-specific shape-bias. On the other hand, we introduce a registration approach that facilitates the mapping of the anatomical model to images acquired by different protocols and modalities, such as functional 3D MR. The new methods are evaluated on clinical MR data, for which considerable improvements can be achieved.

  20. NITRIC OXIDE SYNTHESIS IN MYOCARDIUM FOLLOWING BURN INJURY IN RATS

    Institute of Scientific and Technical Information of China (English)

    王卫东; 陈宗荣; 李蓉; 楼淑芳

    1998-01-01

    The nitric oxide and cyclic GMP production in myocardium early after burn injury in tats were investigated. Nitric oxide synthase activity was measured in cytosols from the left ventricular wall of burned rats.Cytosols from the control group animals were shown to contain mainly Ca2+ dependent nitric oxide synthase (cNOS) with small amount of Ca2+ independent nitric oxide synthase (iNOS). Following burn injury,there was a marked increase in iNOS activity with a peak at 8h post-butyl, however, myocardial cNOS activity was found to decline obviously. Parallel to iNOS induction there was a significant increase in myocardial nitric oxide and cyelic GMP production. All these chenges were alleviated by treatment of the rats with dexamethasone. Since increases in cyclic GMP levels in the heart were associated with reduced myocardial contractility, it is possible that enhanced production of nitric oxide by a Ca2+ independent NO synthase accounts, at least in part, for the depression of myocardial contractility seen in burn animals and patients.

  1. Risk factors and prognosis of ischemic stroke in young patients in Uzbekistan

    Directory of Open Access Journals (Sweden)

    Khurshidakhon Rasulova

    2011-03-01

    Full Text Available Between 2004 and 2008, we studied reasons and risk factors of ischemic stroke in 150 young patients (aged between 17-44 years, compared with those in elderly patients (n=70. According to our data, heredity, arterial hypertension, cerebral vasculitis, thyroid diseases, chronic alcoholism, smoking and long-term use of oral contraceptives are main risk factors of ischemic stroke in the young in Uzbekistan. However, relative risk of stroke in this group of patients is less than in elder patients. In 16% cases, usage of standard diagnostic measures does not lead to identification of the disease cause.

  2. [The features of myocardial deformation of left ventricle in patients with ischemic heart disease defined by the two dimensional strain method].

    Science.gov (United States)

    Galimskaia, V A; Donchenko, I A; Romanovskaia, E M; Oleĭnikov, V É

    2014-01-01

    Aim of this study was to assess qualitative and quantitative features of deformation parameters of left ventricular myocardium in patients with ischemic heart disease (IHD) with and without history of myocardial infarction (MI) using two-dimensional strain imaging. We examined 30 patients with clinical IHD with (group 1, n = 15) and without (group 2, n = 15) history of MI and 20 healthy volunteers. Compared with healthy subjects IHD patients of both groups had reduced longitudinal and circular myocardial deformation. There were no significant differences between patients with IHD and controls in parameters of radial, global, and regional deformation.

  3. EXPERIMENTAL STUDY OF HOMIUM: YAG LASER TRANSMYOCARDIAL REVASCULARIZATION IN ACUTE ISCHEMIC SET TINGS WITH MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    王立清; 胡盛寿; 李澎; 谢峰; 吴清玉; 郭加强

    2000-01-01

    Objective. To study the mechanism and effects of blood perfusion to the acute ischemic region of myocardium through Ho-YAG laser channels with myocardial contrast echocardiography. Methods. To produce the model of acute myocardial ischemia, we partially ligated the left anterior decending (LAD)coronary artery of canine hearts between lst. and 2nd. diagonal branches and then performed transmyocardial revascularization in this region with Ho- YAG laser. Myocardial contrast echocardiography was made with a new gen eration of ultrasound contrast agent and second harmonic imaging of this region before, after ischemia and after laser revascularization. Pictures were taken with “R” wave trigger skill. Results. Acoustic density derterming in the ischemia region (anterior wall)with MCE (myocardial contrast e chocardiography )was obviously decreased( 5.40 ± 1.81) after the LAD was ligated, as compared with before( 11.69 ± 1.61, P < 0.01 ). It was increased remarkably after transmyocardial laser revascularizatuon (TMLR) ( 11.2 ± 2.01, P < 0. 01 )as compared with that when ischemia and approximated to that before ischemia(P > 0.05). There were no dif ferences in acoustic density in the lateral wall(as control)among these comprehensive three periods(P > 0.05). Con trast in the laser region developed one cardiac cycle ahead of that in the non-ischemic normal region. Conclusion. Acute ischemic myocardium can be peffused by oxygenated blood from the left ventricle through Ho YAG laser channels. Evidence of blood perfusion through laser channels during systolic phase was detected, and my ocardial contrast ultrasonography using intravenous perfluorocarbon-exposed sonicated dextrose albumin may be regard ed as a reliable method in the study of transmyocardial revascularization.

  4. Risk factors for ischemic stroke and transient ischemic attack in patients under age 50

    NARCIS (Netherlands)

    Janssen, A.W.M.; Leeuw, F.E. de; Janssen, M.C.H.

    2011-01-01

    To analyze risk factors for ischemic stroke and transient ischemic attack (TIA) in young adults under the age of 50. To make recommendations for additional research and practical consequences. From 97 patients with ischemic stroke or TIA under the age of 50, classical cardiovascular risk factors, co

  5. [Acute postop ischemic hepatitis and hypotension].

    Science.gov (United States)

    Uzhva, V P

    2000-01-01

    The significance of the pronounced durable systemic arterial hypotension (SAH) in the origin of an acute postoperative ischemic hepatitis (APIH) was established, basing on the analysis of 40 clinical observations. Its occurrence is promoted by hemorrhage with 30% and more the circulating blood volume (CBV) deficiency, chronic cardiovascular system and pulmonary diseases, liver cirrhosis, shock, massive infusions of the blood and its components, the abdominal aorta atherosclerosis with stenosis of tr. coeliacus, a. hepatica. Forgoing SAH, the presence of promoting factors, jaundice, the transpherase activity raising in 3-5 times, the level of blood coagulating factors reduction, stable intestinal paresis were diagnostically significant symptoms. Experimental model of an APIH was elaborated in dogs, which occurs due to hypotension, caused by CBV reduction by 40% during two hours. The refractoriness of a. hepatica propria to the blood reinfusion was established. In the APIH occurrence threat the perftoran application in the 20 ml/kg dosage is the prophylaxis method as well as the method of the curative tactics choice. PMID:10857279

  6. Ischemic Stroke and Its Risk Factors in a Registry-Based Large Cross-Sectional Diabetic Cohort in a Country Facing a Diabetes Epidemic

    Directory of Open Access Journals (Sweden)

    Khalid Al-Rubeaan

    2016-01-01

    Full Text Available The main aim of this study is to determine the prevalence and risk factors of ischemic stroke among diabetic patients registered in the Saudi National Diabetes Registry (SNDR database. A cross-sectional sample of 62,681 diabetic patients aged ≥25 years was used to calculate ischemic stroke prevalence and its risk factors. Univariate and multivariate logistic regression analyses were used to assess the roles of different risk factors. The prevalence of ischemic stroke was 4.42% and was higher in the older age group with longer diabetes duration. Poor glycemic control and the presence of chronic diabetes complications were associated with a high risk of ischemic stroke. History of smoking and type 2 diabetes were more frequent among stroke patients. Obesity significantly decreased the risk for ischemic stroke. Regression analysis for ischemic stroke risk factors proved that age ≥45 years, male gender, hypertension, coronary artery disease (CAD, diabetes duration ≥10 years, insulin use, and hyperlipidemia were significant independent risk factors for ischemic stroke. We conclude that ischemic stroke is prevalent among diabetic individuals, particularly among those with type 2 diabetes. Good glycemic, hypertension, and hyperlipidemia control, in addition to smoking cessation, are the cornerstones to achieve a significant reduction in ischemic stroke risk.

  7. Scarred myocardium imposes additional burden on remote viable myocardium despite a reduction in the extent of area with late contrast MR enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Saeed, Maythem; Weber, Oliver; Do, Loi; Martin, Alastair; Saloner, David; Higgins, Charles B. [University of California, Department of Radiology, San Francisco, CA (United States); Lee, Randall J. [University of California, Department of Medicine, San Francisco, CA (United States); Ursell, Philip [University of California, Department of Pathology, San Francisco, CA (United States)

    2006-04-15

    Magnetic resonance imaging (MRI) can simultaneously detect and quantify myocardial dysfunction and shrinkage in contrast-enhanced areas postinfarction. This ability permits the investigation of our hypothesis that transformation of infarcted myocardium to scarred tissue imposes additional burdens on peri-infarcted and remote myocardium. Pigs (n=8) were subjected to reperfused infarction. Gd-DOTA-enhanced inversion recovery gradient echo sequence (IR-GRE) imaging was performed 3 days and 8 weeks postinfarction. Global and regional left ventricular (LV) function was evaluated by cine MRI. Triphenyltetrazolium chloride (TTC) stain was used to delineate infarction while hematoxylin and eosin (H and E) and Masson's trichrome stains were used to characterize remodeled myocardium. Late contrast-enhanced MRIs showed a decrease in the extent of enhanced areas from 17{+-}2% at 3 days to13{+-}1% LV mass at 8 weeks. TTC infarction size was 12{+-}1% LV mass. Cine MRIs showed expansion in dysfunctional area due to unfavorable remodeling, ischemia, or strain. Ejection fraction was reduced in association with increased end-diastolic and end-systolic volumes. Scarred myocardium contained collagen fibers and remodeled thick-walled vessels embedded in collagen. Sequential MRI showed greater LV dysfunction despite the shrinkage in extent of enhanced areas 2 months postinfarction. The integration of late enhancement and cine MRI incorporates anatomical and functional evaluation of remodeled hearts. (orig.)

  8. Inflamação sistêmica causada pela periodontite crônica em pacientes vítimas de ataque cardíaco isquêmico agudo Systemic inflammation caused by chronic periodontitis in acute ischemic heart attack patients

    Directory of Open Access Journals (Sweden)

    Fernando José de Oliveira

    2010-03-01

    Full Text Available OBJETIVO: Processos inflamatórios e infecciosos mediados por bactérias em sítios distantes têm sido descritos como fator de risco à doença coronariana isquêmica aguda (DCIA. MÉTODOS: Cento e oitenta e um pacientes com DCIA, com e sem periodontites crônicas, foram incluídos neste estudo. Os pacientes foram admitidos no HC da UNICAMP e estratificados em três grupos: grupo 1 - pacientes com periodontite crônica grave (31 homens e 19 mulheres; média de idade 55,1 ± 11,29 anos; grupo 2 - pacientes com periodontite crônica leve (40 homens e 28 mulheres; média de idade 54,8 ± 10,37 anos; grupo 3 - pacientes desdentados (43 homens e 20 mulheres; média de idade 67,5 ± 8,55 anos. Amostras sanguíneas foram coletadas para mensurar os perfis lipídico, hematológico e glicêmico. Além disso, biópsias de 17 artérias coronárias com aterosclerose e igual número de artérias mamárias internas sem degeneração aterosclerótica no grupo 1 foram investigadas. Para análise estatística utilizou-se a análise de variância (ANOVA e o teste de Scheffé para comparações múltiplas. RESULTADOS: Triglicérides e LDL estavam elevados no grupo 1 em relação ao grupo 2. O HDL apresentou-se reduzido em 20% dos pacientes do grupo 1, e em 8% nos desdentados. A glicemia estava elevada no grupo 1. DNA de bactérias periodontais foram detectados em 58,8% das artérias coronárias. CONCLUSÕES: Pacientes com DCIA e periodontite crônica grave podem apresentar perfil lipídico alterado, como também microorganismos associados com as periodontites crônicas graves podem permear dentro de vasos coronarianos.OBJECTIVE: Infectious and inflammatory processes mediated by bacteria in distant sites have been described as a risk factor for acute ischemic heart disease (AIHD. METHODS: One hundred one patients with AIHD with and without chronic periodontitis (CP were included in this study. Patients were admitted to the HC UNICAMP and stratified into three

  9. ST/HR slope和功率踏车的慢性心肌缺血诊断系统的设计%Design of chronic myocardial ischemic diagnose system based on ST/HR slope and power test bicycle

    Institute of Scientific and Technical Information of China (English)

    罗小刚; 范超; 彭承琳; 郑小林; 王远亮

    2009-01-01

    针对传统的运用心电试验法诊断慢性心肌缺血时存在的一些缺陷:受试人员做运动试验时对于心电信号的干扰大、运动平板的适用人群有一定的限制、ST段压低的诊断指标敏感性和特异性都不高,设计了基于ST/HR slope诊断指标、功率踏车为运动试验装置的慢性心肌缺血诊断系统.ST/HR slope诊断指标通过计算机程序自动计算获得,免去了人工计算的繁琐与较大的误差;功率踏车能够有效的填补运动平板的应用空缺,降低运动时对心电采集的干扰.经过实验验证,证明该系统与传统系统相比较具有明显的优势,能够为运动心电试验法提供更高的诊断敏感性(93.8%)和特异性(94.5%).%There are some disadvantages in the traditional ECG exercise, such as noises in the acquired ECG, restrictions on the kind of patient who can use this method and the low sensitivity and specificity for the ST depression diagnostic metrics. New equipment for diagnosing Chronic Myocardial Ischemia based on ST/HR slope and power test bicycle is designed. The ST/HR slope is calculated with computer software, avoiding heavy burden and errors for human computation. The power test bicycle decreased noises and improved other disadvantages for treadmill. It is demonstrated with experiments that this system yields better performance with higher sensitivity (93.8%) and specificity (94.5%) than the traditional system does.

  10. Effects of statins on the liver: clinical analysis of patients with ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li-san; LIU Zheng-xia; L(U) Wen; HU Xing-yue

    2011-01-01

    Background Statins are one of the most common agents prescribed for ischemic stroke patients, but their side effects on the liver are worrisome to both physicians and patients. This study aimed to analyze the features and related factors of the hepatic side effects of, statins in patients with ischemic troke.Methods Four hundred and eighty-one patients with ischemic stroke who had been treated with statins at our department from July 1, 2008 to June 30, 2009 were investigated retrospectively. Liver function, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), within 6 months after they began to use statins and related factors were analyzed.Results The incidence of mild ALT and AST elevation, less than three times the upper limit of normal, and the incidence of moderate elevation, ALT and AST levels 3-10 times the upper limit of normal, in ischemic stroke patients who had been treated with statins were 2.3% and 2.1%, respectively. These incidences were higher than in patients with common hyperlipidemia or coronary heart disease. The relatively high incidence was associated with older age (>65 years) and chronic liver diseases, and was not related to the type of stroke, gender, and reduction of low-density lipoprotein. The levels of ALT and AST normalized after withdrawal of statins or lowering the dosage. None of the patients developed hepatic failure.Conclusions Asymptomatic elevation of ALT and AST after administration of statins is more likely to occur in ischemic stroke patients than in others, and the elevation is related to age and chronic liver diseases. However, statins are still safe for ischemic stroke patients.

  11. The effect of adrenergic receptor—adenyl cyclase system on myocardial ischemic preconditioning in rats

    Institute of Scientific and Technical Information of China (English)

    LANXiao-Li; LANJi-Cheng; 等

    2002-01-01

    In order to study the effects of every part of adrenergic receptor-adenyl cyclase system on ischemic preconditioning of myocardium in rats in vivo,SD rats were divided into three groups:IP group,I/R group and CON group.Rate were received surgical procedure and undergone left coronary artery occlusion and reperfusion.Hearts were extracted to analyze the infarct size by TTC staining,to measure serum myocardial enzymes,to study β-AR Bamx and Kd by radioligand binding assay of receptors(RAB),and to check the activity of AC and the content of cAMP by radioimmunoassay(RIA).The infarct area was found much smaller in IP group than I/R group(P<0.001);CK,CK-MB and LDH were found significantly higher in I/R group (P<0.001),The Bmax of β-AR in IP group were higher than in I/R group (P<0.001), No difference of Kd could be seen between IP and I/R group,In IP group,the activity of Ac and the content of cAMP were higher than I/R group(P<0.05 and 0.001,respectively).It is concluded that ischemic preconditioning can protect the hearts from necrosis and reduce endo-enzyme leakage.The system of adrenergic receptor-adenyl cyclase system probably takes part in the protection of the IP.

  12. Perinatal Hypoxic-Ischemic Encephalopathy

    Directory of Open Access Journals (Sweden)

    Ming-Chi Lai

    2011-01-01

    Full Text Available Perinatal hypoxic-ischemic encephalopathy (HIE is an important cause of brain injury in the newborn and can result in long-term devastating consequences. Perinatal hypoxia is a vital cause of long-term neurologic complications varying from mild behavioural deficits to severe seizure, mental retardation, and/or cerebral palsy in the newborn. In the mammalian developing brain, ongoing research into pathophysiological mechanism of neuronal injury and therapeutic strategy after perinatal hypoxia is still limited. With the advent of promising therapy of hypothermia in HIE, this paper reviews the pathophysiology of HIE and the future potential neuroprotective strategies for clinical potential for hypoxia sufferers.

  13. IS THERE AN ALTERNATIVE TO EJECTION FRACTION IN INSTRUMENTAL EVALUATION OF CHRONIC HEART FAILURE SEVERITY IN POST-MYOCARDIAL INFARCTION PATIENTS?

    Directory of Open Access Journals (Sweden)

    T. A. Kazakovtseva

    2010-01-01

    Full Text Available Aim. To find echocardiographic indicators of the heart remodeling which provide the best evaluation of chronic heart failure (CHF severity in post-myocardial infarction patients.Material and methods. Patients (n=100 with CHF related with ischemic heart disease (post-myocardial infarction have been examined. The CHF severity was assessed by Scale of Clinical State Evaluation (SCSE in V.Yu. Mareev's modification and 6-minute walk test. The echocardiography was performed with registration of the heart cavities size, left ventricle (LV myocardium mass, LV asynergy index, LV sphericity index, time of LV isovolumic contraction and relaxation, Е/А ratio for mitral flow, grade of valvular regurgitation and pulmonary hypertension.Results. The maximal correlation values of CHF severity was observed with intensity of diastolic dysfunction, systolic LV size and volume, LV asynergia index, integrated systolic remodeling index, degree of mitral regurgitation. Correlation value of CHF severity with LV ejection fraction was less than this with above mentioned indices.Conclusion. The early echocardiographic markers of CHF were found. These are LV systolic sphericity index, LV integrated systolic remodeling index, LV systolic myocardial stress.

  14. Remote Ischemic Conditioning: Its Benefits and Limitations.

    Science.gov (United States)

    Kloner, Robert A

    2016-03-01

    This editorial describes benefits and limitations of remote ischemic conditioning. Remote ischemic conditioning was shown to reduce myocardial intact size in at least 4 sizeable clinical trials of acute myocardial infarction. It was not effective in recent studies of cardiac surgery. Reasons for these differences are discussed.

  15. Persimmon leaf flavonoid promotes brain ischemic tolerance**

    Institute of Scientific and Technical Information of China (English)

    Mingsan Miao; Xuexia Zhang; Ming Bai; Linan Wang

    2013-01-01

    Persimmon leaf flavonoid has been shown to enhance brain ischemic tolerance in mice, but its mechanism of action remains unclear. The bilateral common carotid arteries were occluded using a micro clip to block blood flow for 10 minutes. After 10 minutes of ischemic preconditioning, 200, 100, and 50 mg/kg persimmon leaf flavonoid or 20 mg/kg ginaton was intragastrical y administered per day for 5 days. At 1 hour after the final administration, ischemia/reperfusion models were estab-lished by blocking the middle cerebral artery for 2 hours. At 24 hours after model establishment, compared with cerebral ischemic rats without ischemic preconditioning or drug intervention, plasma endothelin, thrombomodulin and von Wil ebrand factor levels significantly decreased and intercel-lular adhesion molecule-1 expression markedly reduced in brain tissue from rats with ischemic pre-conditioning. Simultaneously, brain tissue injury reduced. Ischemic preconditioning combined with drug exposure noticeably improved the effects of the above-mentioned indices, and the effects of 200 mg/kg persimmon leaf flavonoid were similar to 20 mg/kg ginaton treatment. These results indicate that ischemic preconditioning produces tolerance to recurrent severe cerebral ischemia. However, persimmon leaf flavonoid can elevate ischemic tolerance by reducing inflammatory reactions and vascular endothelial injury. High-dose persimmon leaf flavonoid showed an identical effect to ginaton.

  16. Persistent cognitive impairment after transient ischemic attack

    NARCIS (Netherlands)

    Rooij, F.G. van; Schaapsmeerders, P.; Maaijwee, N.A.; Duijnhoven, D.A. van; Leeuw, F.E. de; Kessels, R.P.; Dijk, E.J. van

    2014-01-01

    BACKGROUND AND PURPOSE: By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whe

  17. Persistent Cognitive Impairment After Transient Ischemic Attack

    NARCIS (Netherlands)

    Rooij, F.G. van; Schaapsmeerders, P.; Maaijwee, N.A.M.M.; Duijnhoven, D.A. van; de Leeuw, F.E.; Kessels, R.P.C.; Dijk, E.J. van

    2014-01-01

    Background and Purpose—By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whet

  18. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  19. Early changes in contractility and coronary blood flow in the normal areas of the ischemic porcine heart.

    Science.gov (United States)

    Pashkow, F; Holland, R; Brooks, H

    1977-03-01

    The regional responses of normal myocardium distant from an ischemic area were studied during acute anterior descending occlusion in the open-chest chloralose-anesthetized pig. Three markers of regional response in both normal and ischemic areas were used: surface ECG electrode, a force gauge in series with left ventricular outer wall fibers, and coronary blood inflow to each region as determined by electromagnetic cuff-probes. Following brief anterior descending artery occlusion (120 sec)., a characteristic rapid decline in contractile force and evolution of TQ-ST segment changes was observed in the ischemic area. In contrast, in the distant area increases in contractil force (p less than 0.001) and coronary blood flow (p less than 0.002) occurred. These distant responses were essentially obliterated following transection and cannulation of the artery supplying this region (p less than 0.05). The findings are consistent with a reflex neurovascular mechanism operating within the intact heart. This reflex is rapidly activated in order to maintain adequate levels of cardiac performance despite sudden loss of functional myocardial mass.

  20. Targeting acid sphingomyelinase reduces cardiac ceramide accumulation in the post-ischemic heart.

    Science.gov (United States)

    Klevstig, Martina; Ståhlman, Marcus; Lundqvist, Annika; Scharin Täng, Margareta; Fogelstrand, Per; Adiels, Martin; Andersson, Linda; Kolesnick, Richard; Jeppsson, Anders; Borén, Jan; Levin, Malin C

    2016-04-01

    Ceramide accumulation is known to accompany acute myocardial ischemia, but its role in the pathogenesis of ischemic heart disease is unclear. In this study, we aimed to determine how ceramides accumulate in the ischemic heart and to determine if cardiac function following ischemia can be improved by reducing ceramide accumulation. To investigate the association between ceramide accumulation and heart function, we analyzed myocardial left ventricle biopsies from subjects with chronic ischemia and found that ceramide levels were higher in biopsies from subjects with reduced heart function. Ceramides are produced by either de novo synthesis or hydrolysis of sphingomyelin catalyzed by acid and/or neutral sphingomyelinase. We used cultured HL-1 cardiomyocytes to investigate these pathways and showed that acid sphingomyelinase activity rather than neutral sphingomyelinase activity or de novo sphingolipid synthesis was important for hypoxia-induced ceramide accumulation. We also used mice with a partial deficiency in acid sphingomyelinase (Smpd1(+/-) mice) to investigate if limiting ceramide accumulation under ischemic conditions would have a beneficial effect on heart function and survival. Although we showed that cardiac ceramide accumulation was reduced in Smpd1(+/-) mice 24h after an induced myocardial infarction, this reduction was not accompanied by an improvement in heart function or survival. Our findings show that accumulation of cardiac ceramides in the post-ischemic heart is mediated by acid sphingomyelinase. However, targeting ceramide accumulation in the ischemic heart may not be a beneficial treatment strategy. PMID:26930027

  1. Quantitative ontogenetic assessment of connective tissue cell dynamics in the ventricular rat myocardium

    Directory of Open Access Journals (Sweden)

    Gorbunov A.A.

    2008-01-01

    Full Text Available In this work the dynamics of connective tissue cell number in nonvascular stroma have been studied in different myocardial sites of left and right ventricles in rat hearts during prenatal and early postnatal periods of ontogenesis. The materials of study were hearts of 115 white rats. It has been studied 10 age groups – from 14 days of prenatal development to 20 days of postnatal life. Nonvascular stromal cell quantitative density was estimated by calculation of there nuclei count referred to the square of the cut. During prenatal development it have been studied separately the compact layer and trabecular layer of myocardium, during postnatal period – subendocardial, intramural and subepicardial layers of myocardium. Following pre-sent study a quantitative evaluation of the connective tissue cell number dynamics has been evaluated in ventricular myocardium. The most intensive stromal cell number dynamics in the myocardium have been documented twice – at 14-16 days of embryologic development and at first two weeks after birth. The dynamics in connective tissue cells number during prenatal period had more prominent rate in the compact layer of myocardium in comparison with the trabecular layer. This pattern may point to cellular migration from the developing epicardium toward endocardium. At every stage of cardiogenesis the dynamics in quantitative changes in myocardial connective tissue component correlated with myocardiocyte differentia-tion and microvasculature formation.

  2. Dopamine-induced cyclic AMP increase in canine myocardium, kidney and superior mesenteric artery.

    Directory of Open Access Journals (Sweden)

    Kazuno,Hiroshi

    1982-04-01

    Full Text Available The effect of dopamine on cyclic AMP levels in tissue slices of canine myocardium and kidney, and in chopped superior mesenteric arterial wall was investigated to identify dopamine receptors. Tissues were incubated in modified Krebs-Henseleit Ringer bicarbonate solution at 37 degrees C for 20 min with test drugs, after 20-min preincubation. In the presence of 3-isobutyl-1-methylxanthine (IBMX, dopamine and apomorphine caused dose-dependent increases in cyclic AMP levels in the myocardium, kidney and superior mesenteric artery. Phentolamine significantly intensified the cyclic AMP-increasing effect of dopamine in the superior mesenteric artery, but it did not influence the cyclic AMP increase caused by dopamine or apomorphine in the myocardium and kidney. Propranolol markedly blocked the effect of dopamine on cyclic AMP levels in all tissues studied. Haloperidol slightly inhibited the effect of dopamine and completely blocked the effect of apomorphine in the myocardium and kidney. These data suggest that dopamine increases cyclic AMP levels by activating predominantly beta-adrenergic receptors and partly dopamine receptors in the canine myocardium, kidney and superior mesenteric artery. The present results also suggest that dopamine acts not only on beta-adrenergic and dopamine receptors but also on alpha-adrenergic receptors in the superior mesenteric artery. Contrary to the activation of beta-adrenergic and dopamine receptors, the activation of alpha-adrenergic receptors resulted in a decrease in cyclic AMP levels in this tissue.

  3. Effect of berberine on Cdk9 and cyclin T1 expressions in myocardium of diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Zhou Jiyin; Zhou Shiwen; Tang Jianlin; Xu Ying; Ying Yi

    2008-01-01

    Objective: To investigate the effect of berberine, one of the main alkaloids of Rhizoma coptidis, on myocardial orphology and the expressions of cyclin-dependent kinase 9 (Cdk9) and cyclin T1 protein in the myocardium of type diabetic rats. Methods: Type 2 diabetes mellitus rats were induced by an injection of 35 mg/kg streptozotocin (STZ) nd a high-carbohydrate/high-fat diet for 16 weeks. Diabetic rats were given low-, middle-, high-dose berberine (75,150, 300 mg/kg), fenofibrate (100 mg/kg) and rosiglitazone (4 mg/kg) for another 16 weeks, respectively. The myocardium structure was observed with hematoxylin & eosin (H&E) staining and Cdk9 and cyclin T1 protein expressions were detected by immunohistochemistry. Results: Middle-dose, high-dose berberine improved myocardial hypertrophy and interstitial fibrosis of diabetic rats. Cdk9 and cyclin T1 protein were significantly lower in diabetic myocardium than in control one (P<0.01), and middle-dose, high-dose berberine and fenofibrate obviously increased oth Cdk9 and cyclin T1 expression to near control level (P<0.01). Conclusion: Berberine modulates Cdk9 and cyclin I protein expression in diabetic myocardium which may contribute to ameliorate myocardium damage.

  4. Morbidity predictors in ischemic stroke

    Directory of Open Access Journals (Sweden)

    Panicker J

    2003-01-01

    Full Text Available Background: Although ischemic CVA is one of the leading causes for death and disability, parameters for predicting long-term outcome in such patients have not been clearly delineated, especially in the Indian context. Methods: A prospective hospital-based study of 105 patients of ischemic stroke, focal neurological deficits and functional score was assessed and the C-reactive protein level (CRP was measured. A follow-up was done at 5 days and at 6 months and outcome variable was the functional status at 6 months using Barthel Index of Activities of Daily Living. Accordingly, patients were grouped into 3 - Barthel Index < 41: Severely disabled, Barthel Index 41-60: Moderately disabled and Barthel Index > 60: Mildly disabled. Results: At admission, if upper limb power was less than Medical Research Council (MRC grade 4, or aphasia was present or CRP assay was positive, then at 6 months, these patients most likely belonged to the severely disabled group. If upper limb or lower limb power was greater than MRC grade 3 or there was no aphasia or conjugate gaze deviation or CRP assay was negative, these patients most likely belonged to the mildly disabled group at 6 months. Follow-up rate was 86%. Conclusion: Patients can be stratified according to the predicted prognosis. The treatment and rehabilitation can be properly planned and strictly adhered to in patients predicted to have worse prognosis.

  5. Swallowing disorders after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Gabriela Camargo Remesso

    2011-10-01

    Full Text Available OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7 (p<0.001. Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001 and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001. CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

  6. A "second window of protection" occurs 24 h after ischemic preconditioning in the rat heart.

    Science.gov (United States)

    Yamashita, N; Hoshida, S; Taniguchi, N; Kuzuya, T; Hori, M

    1998-06-01

    We and others found that cardioprotection is acquired not only soon after, but also 24 h after ischemic preconditioning in canine and rabbit myocardial infarction models (second window of protection). However, a second window phenomenon against myocardial infarction was dependent on species limitations and has not been observed in porcine hearts. In this study, we examined whether the "second window of protection" against myocardial infarction is observed in the rat heart. In the ischemic preconditioning (IP) group, the left main coronary artery (LCA) of rats was occluded four times for 3 min. each separated by reperfusion for 10 min. After 0, 3, and 24 h, the rats were subjected to a 20-min LCA occlusion followed by 48-h reperfusion. At 0 and 24 h after IP, infarct size and the incidence of ventricular fibrillation (VF) during ischemia were significantly reduced compared with corresponding sham-operated groups without preconditioning. After 3 h of IP, there were no differences either in the incidence of VF during ischemia or in infarct size. Manganese superoxide dismutase (Mn-SOD) content in ischemic (LCA) region of myocardium significantly increased as compared with that of sham-operated rats 24 h after IP. Treatment with N-2-mercaptopropionyl glycine, an antioxidant and a hydroxyl radical scavenger, during IP abolished the early-phase (0 h after IP) and late-phase (24 h after IP) cardioprotection and the corresponding late increase in Mn-SOD content. These results indicate that a "second window of protection" against myocardial infarction also exists in rat hearts and the induction of an intrinsic scavenger, Mn-SOD, via free radical production during IP may be important in the second window of protection. PMID:9689592

  7. Analysis of Mitochondrial Proteins in the Surviving Myocardium after Ischemia Identifies Mitochondrial Pyruvate Carrier Expression as Possible Mediator of Tissue Viability.

    Science.gov (United States)

    Fernández-Caggiano, Mariana; Prysyazhna, Oleksandra; Barallobre-Barreiro, Javier; CalviñoSantos, Ramón; Aldama López, Guillermo; Generosa Crespo-Leiro, Maria; Eaton, Philip; Doménech, Nieves

    2016-01-01

    The endogenous mechanisms contributing to tissue survival following myocardial infarction are not fully understood. We investigated the alterations in the mitochondrial proteome after ischemia-reperfusion (I/R) and its possible implications on cell survival. Mitochondrial proteomic analysis of cardiac tissue from an in vivo porcine I/R model found that surviving tissue in the peri-infarct border zone showed increased expression of several proteins. Notably, these included subunits of the mitochondrial pyruvate carrier (MPC), namely MPC1 and MPC2. Western blot, immunohistochemistry, and mRNA analysis corroborated the elevated expression of MPC in the surviving tissue. Furthermore, MPC1 and MPC2 protein levels were found to be markedly elevated in the myocardium of ischemic cardiomyopathy patients. These findings led to the hypothesis that increased MPC expression is cardioprotective due to enhancement of mitochondrial pyruvate uptake in the energy-starved heart following I/R. To test this, isolated mouse hearts perfused with a modified Krebs buffer (containing glucose, pyruvate, and octanoate as metabolic substrates) were subjected to I/R with or without the MPC transport inhibitor UK5099. UK5099 increased myocardial infarction and attenuated post-ischemic recovery of left ventricular end-diastolic pressure. However, aerobically perfused control hearts that were exposed to UK5099 did not modulate contractile function, although pyruvate uptake was blocked as evidenced by increased cytosolic lactate and pyruvate levels. Our findings indicate that increased expression of MPC leads to enhanced uptake and utilization of pyruvate during I/R. We propose this as a putative endogenous mechanism that promotes myocardial survival to limit infarct size.

  8. ISCHEMIA in chronic kidney disease: improving the representation of patients with chronic kidney disease in cardiovascular trials.

    Science.gov (United States)

    Wyatt, Christina M; Shineski, Matthew; Chertow, Glenn M; Bangalore, Sripal

    2016-06-01

    Despite the high cardiovascular risk associated with chronic kidney disease, a recent systematic review confirmed that patients with kidney disease remain underrepresented in cardiovascular trials. Two ongoing trials are assessing the risk:benefit of aggressive evaluation and intervention for ischemic heart disease in patients with advanced chronic kidney disease.

  9. Functional reconstruction of ischemic contracture in the

    Directory of Open Access Journals (Sweden)

    TANG Hao

    2011-04-01

    Full Text Available 【Abstract】Objective: To discuss the method of functional reconstruction of ischemic contracture in the lower limb and propose a classification protocol for ischemic contracture in the lower limb based on its severity and prognosis. Methods: A total of 42 patients with ischemic contracture in the lower limb were included in this study. According to different types of disturbance and degrees of severity, surgical reconstructions consisting of nerve decompression, tendon lengthening or transfer, intrinsic foot muscle release and sural-tibial nerve anastomosis were performed in every patient. Results: Postoperatively, all patients were able to walk on flat ground. Drop foot was corrected in 10 patients, and 5 patients still felt some difficulty during stair activity. Split Achilles tendon transfer to flexor hallucis longus tendon was performed in 12 patients, and their walking stability was improved. Seven patients accepted ipsilateral suraltibial nerve anastomosis, and sensitivity recovery reached to S2 in 2 patients and S3 in 5 patients. Conclusions: Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb. Key words: Ischemic contracture; Classification; Recovery of function

  10. Immune mechanisms in cerebral ischemic tolerance

    Directory of Open Access Journals (Sweden)

    Lidia eGarcia-Bonilla

    2014-03-01

    Full Text Available Stressor-induced tolerance is a central mechanism in the response of bacteria, plants, and animals to potentially harmful environmental challenges. This response is characterized by immediate changes in cellular metabolism and by the delayed transcriptional activation or inhibition of genetic programs that are not generally stressor specific (cross-tolerance. These programs are aimed at countering the deleterious effects of the stressor. While induction of this response (preconditioning can be established at the cellular level, activation of systemic networks is essential for the protection to occur throughout the organs of the body. This is best signified by the phenomenon of remote ischemic preconditioning, whereby application of ischemic stress to one tissue or organ induces ischemic tolerance in remote organs through humoral, cellular and neural signaling. The immune system is an essential component in cerebral ischemic tolerance acting simultaneously both as mediator and target. This dichotomy is based on the fact that activation of inflammatory pathways is necessary to establish ischemic tolerance and that ischemic tolerance can be, in part, attributed to a subdued immune activation after index ischemia. Here we describe the components of the immune system required for induction of ischemic tolerance and review the mechanisms by which a reprogrammed immune response contributes to the neuroprotection observed after preconditioning. Learning how local and systemic immune factors participate in endogenous neuroprotection could lead to the development of new stroke therapies.

  11. Preliminary study on the effect of chronic nicotine intake on cerebral edema induced by ischemic reperfusion in rats%慢性摄入尼古丁加重大鼠脑缺血再灌注损伤性脑水肿的初步研究

    Institute of Scientific and Technical Information of China (English)

    陈晓; 赵津京; 蒋功达; 徐烈钧; 段喜森; 佘志峰; 陈炜炜; 潘树义

    2014-01-01

    Objective To observe the effect of chronic nicotine intake on cerebral edema induced by ischemic reperfusion in rats and also to investigate the mechanism involved.Methods Ninety male SD rats,with an age of 10 weeks,were randomly divided into the normal saline group (n =45),and the nicotine group (n =45).The animals in the 2 groups were respectively given physiological saline (0.5 ml/kg · d) and nicotine (subcutaneous injection with nicotine at a dosage of 3mg/kg · d) for 6 weeks.After 6 weeks,models of cerebral injury induced by ischemic reperfusion were developed,and occurrence and seriousness of cerebral edema were observed at 5 different time points (there were 9 animals in each group at each different time point).Endothelial cell strains from cerebral micro vessels,bEnd.3,were collected for culture from the animals of the control group and the nicotine group.The animals in the nicotine group were further divided into zthe nicotine group (1μmol/L) and the nicotine + α-bungarotoxin group (nicotine 1 μmol/L,α-bungarotoxin 0.1μmol/L).Changes in cell permeability and the expressions of aquaporin 1 (AQP1) were detected in the animals of the 3 groups.Results Three hours after ischemic reperfusion,cerebral edema in the animals of the nicotine group obviously worsened,as compared with that of the animals in the control group.Cerebral water contents of the 2 groups came to peak levels at 12.0 h after ischemic reperfusion,reaching the levels of(86.53 ± 2.26) % and(90.47 ± 1.94) % respectively,with statistical significance (P < 0.01).Detection of bEnd.3 in the cerebral micro-vessel endothelial cell strains revealed that cell permeability in the nicotine group [(114 ± 15)%] was significantly higher than that of the control group [(100 ± 13)%],with statistical significance (P <0.01).Cell permeability in the nicotine + α-bungarotoxin group significantly improved,as compared with that of the nicotine group,also with statistical significance(P < 0

  12. Characteristics of Misclassified CT Perfusion Ischemic Core in Patients with Acute Ischemic Stroke.

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    Ralph R E G Geuskens

    Full Text Available CT perfusion (CTP is used to estimate the extent of ischemic core and penumbra in patients with acute ischemic stroke. CTP reliability, however, is limited. This study aims to identify regions misclassified as ischemic core on CTP, using infarct on follow-up noncontrast CT. We aim to assess differences in volumetric and perfusion characteristics in these regions compared to areas that ended up as infarct on follow-up.This study included 35 patients with >100 mm brain coverage CTP. CTP processing was performed using Philips software (IntelliSpace 7.0. Final infarct was automatically segmented on follow-up noncontrast CT and used as reference. CTP and follow-up noncontrast CT image data were registered. This allowed classification of ischemic lesion agreement (core on CTP: rMTT≥145%, aCBV<2.0 ml/100g and infarct on follow-up noncontrast CT and misclassified ischemic core (core on CTP, not identified on follow-up noncontrast CT regions. False discovery ratio (FDR, defined as misclassified ischemic core volume divided by total CTP ischemic core volume, was calculated. Absolute and relative CTP parameters (CBV, CBF, and MTT were calculated for both misclassified CTP ischemic core and ischemic lesion agreement regions and compared using paired rank-sum tests.Median total CTP ischemic core volume was 49.7ml (IQR:29.9ml-132ml; median misclassified ischemic core volume was 30.4ml (IQR:20.9ml-77.0ml. Median FDR between patients was 62% (IQR:49%-80%. Median relative mean transit time was 243% (IQR:198%-289% and 342% (IQR:249%-432% for misclassified and ischemic lesion agreement regions, respectively. Median absolute cerebral blood volume was 1.59 (IQR:1.43-1.79 ml/100g (P<0.01 and 1.38 (IQR:1.15-1.49 ml/100g (P<0.01 for misclassified ischemic core and ischemic lesion agreement, respectively. All CTP parameter values differed significantly.For all patients a considerable region of the CTP ischemic core is misclassified. CTP parameters significantly

  13. Granulocyte-colony stimulating factor therapy to induce neovascularization in ischemic heart disease

    DEFF Research Database (Denmark)

    Ripa, Rasmus Sejersten

    2012-01-01

    Cell based therapy for ischemic heart disease has the potential to reduce post infarct heart failure and chronic ischemia. Treatment with granulocyte-colony stimulating factor (G-CSF) mobilizes cells from the bone marrow to the peripheral blood. Some of these cells are putative stem or progenitor...... infarction or severe chronic ischemic heart disease. In addition, we assed a number of factors that could potentially affect the effect of cell based therapy. Finally, we intended to develop a method for in vivo cell tracking in the heart. Our research showed that subcutaneous G-CSF along with gene therapy...... cells. G-CSF is injected subcutaneously. This therapy is intuitively attractive compared to other cell based techniques since repeated catheterizations and ex vivo cell purification and expansion are avoided. Previous preclinical and early clinical trials have indicated that treatment with G-CSF leads...

  14. Insulin-Like Growth Factor-1 (IGF-1 Reduces ischemic changes and increases circulating angiogenic factors in experimentally - induced myocardial infarction in rats

    Directory of Open Access Journals (Sweden)

    Lisa Mathews

    2011-06-01

    Full Text Available Abstract Background Coronary artery disease is a global health concern in the present day with limited therapies. Extensive efforts have been devoted to find molecular therapies to enhance perfusion and function of the ischemic myocardium. Aim of the present study was to look into the effects of insulin like growth factor -1 (IGF-1 on circulating angiogenic factors after myocardial ischemia in rats. Methods Adult male Sprague-Dawley rats were randomly divided into 10-days control, myocardial infarction, IGF-1 alone (2 μg/rat/day and ISO+IGF-1 groups. Isoproterenol (ISO, a synthetic catecholamine was used to induce myocardial infarction. Serum transforming growth factor-β (TGF-β and vascular endothelial growth factor (VEGF levels were checked after 10-days of IGF-1 administration. Results There was a significant increase in heart weight after IGF-1 treatment. A significant increase in cardiac enzyme level (CK-MB and LDH was seen in isoproterenol treated rats when compared to control group. IGF-1treatment induced a significant increase in serum angiogenic factors, IGF-1, VEGF and TGF beta levels. IGF-1 also reduced the ischemic changes in the myocardium when compared to the isoproterenol alone treated group. Conclusions In conclusion, treatment with insulin-like growth factor-1 (IGF-1 in myocardial infarction significantly increased circulating angiogenic growth factors like IGF-1, VEGF and TGF beta thus, protecting against myocardial ischemia.

  15. Evaluation of global longitudinal strain of left ventricle and regional longitudinal strain in the region of left ventricular leads predicts the response to cardiac resynchronization therapy in patients with ischemic heart failure.

    Science.gov (United States)

    Ma, Chun-Yan; Liu, Shuang; Yang, Jun; Tang, Li; Zhang, Li-Ming; Li, Nan; Yu, Bo

    2014-09-01

    Myocardium viability in ischemic heart failure (HF) may affect the effect of cardiac resynchronization therapy (CRT). We hypothesized that longitudinal strain of 2D-STE, which reflects myocardium viability, can predict the response to CRT in patients with ischemic HF. 2D-STE was performed in 42 patients with HF, 1 week before and 1 year after CRT. GLS, RLS, and the LV synchrony index (SI), defined as the difference in timing to peak radial strain between LV anterior septal and posterior wall in LV short axis view, were calculated. A decrease in the LV end-systolic volume (LVESV) value of ≥ 15 % 1 year after CRT was defined as response to CRT. Twenty-nine patients responded to CRT (CRT-R group), while 13 patients did not respond and were assigned as CRT-NR group. Pre-CRT RLS and GLS were higher, while SI is lower, in CRT-R patients compared with CRT-NR group (p < 0.001). The ROC curve revealed that RLS of -11.5 % predicted response to CRT with sensitivity of 80.0 % and specificity of 77.9 % (AUC = 0.84, p < 0.001). Further, GLS of -13 % predicted response to CRT with sensitivity of 73.0 % and specificity of 73.4 % (AUC = 0.79, p < 0.001). In conclusion, LV dyssynchrony, GLS, and RLS calculated by 2D-STE can predict long-term response to CRT in patients with ischemic HF.

  16. Pre-ischemic exercise alleviates oxidative damage following ischemic stroke in rats

    OpenAIRE

    Feng, Rui; Zhang, Min; Wang, Xiao; Li, Wen-bin; REN, SHI-QING; Feng ZHANG

    2014-01-01

    Physical exercise has been proved to be neuroprotective in clinical trials and animal experiments. However, the exact mechanism underlying this neuroprotective effect remains unclear. The aim of the present study was to explore whether pre-ischemic treadmill training could act as a form of ischemic preconditioning in a rat following ischemic stroke by reducing oxidative damage. Fifty-four rats were randomly divided into three groups (n=18 per group): Sham surgery, middle cerebral artery occlu...

  17. Chronic Diarrhea

    Science.gov (United States)

    ... infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  18. Changes of IK,ATP current density and allosteric modulation during chronic atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    WU Gang; HUANG Cong-xin; TANG Yan-hong; JIANG Hong; WAN Jun; CHEN Hui; XIE Qiang; HUANG Zheng-rong

    2005-01-01

    Background Atrial fibrillation (AF) is the most common supraventricular arrhythmia in clinical practice. Chronic atrial fibrillation (CAF) is associated with ionic remodeling. However, little is known about the activity of ATP-sensitive potassium current (IK,ATP) during CAF. So we studied the changes of IK,ATP density and allosteric modulation of ATP-sensitivity by intracellular pH during CAF.Methods Myocardium samples were obtained from the right auricular appendage of patients with rheumatic heart disease complicated with valvular disease in sinus rhythm (SR) or CAF. There were 14 patients in SR group and 9 patients in CAF group. Single atrial cells were isolated using an enzyme dispersion technique. IK,ATP was recorded using the whole-cell and inside-out configuration of voltage-clamp techniques. In whole-cell model, myocytes of SR and CAF groups were perfused with simulated ischemic solution to elicit IK,ATP. In inside-out configuration, the internal patch membranes were exposed to different ATP concentrations in pH 7.4 and 6.8.Results Under simulated ischemia, IK,ATP current density of CAF group was significantly higher than in SR group [(83.5±10.8) vs. (58.7±8.4) pA/pF, P<0.01]. IK,ATP of the two groups showed ATP concentration-dependent inhibition. The ATP concentration for 50% current inhibition (IC50) for the SR group was significantly different in pH 7.4 and pH 6.8 (24 vs. 74 μmol/L, P<0.01). The IC50 did not change significantly in CAF group when the pH decreased from 7.4 to 6.8.Conclusions During CAF, IK,ATP current density was increased and its allosteric modulation of ATP-sensitivity by intracellular pH was diminished.

  19. 25-Hydroxyvitamin D and symptomatic ischemic stroke

    DEFF Research Database (Denmark)

    Brøndum-Jacobsen, Peter; Nordestgaard, Børge G; Schnohr, Peter;

    2013-01-01

    OBJECTIVE: We tested the hypothesis that low plasma concentrations of 25-hydroxyvitamin D are associated with increased risk of symptomatic ischemic stroke in the general population. METHODS: We measured plasma 25-hydroxyvitamin D in 10,170 individuals from the general population, the Copenhagen...... City Heart Study. During 21 years of follow-up, 1,256 and 164 persons developed ischemic and hemorrhagic stroke, respectively. In a meta-analysis of ischemic stroke, we included 10 studies, 58,384 participants, and 2,644 events. RESULTS: Stepwise decreasing plasma 25-hydroxyvitamin D concentrations...... were associated with stepwise increasing risk of ischemic stroke both as a function of seasonally adjusted percentile categories and as a function of clinical categories of 25-hydroxyvitamin D (p for trend ≤ 2 × 10(-3) ). In a Cox regression model comparing individuals with plasma 25-hydroxyvitamin D...

  20. Early Arterial Ischemic Stroke in Premature Infants

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-05-01

    Full Text Available Presentation, clinical course, and outcomes for 23 premature children with arterial ischemic stroke before 44 weeks gestational age are reported from Riley Hospital for Children, Indianapolis, IN.

  1. Molecular Mechanisms of Renal Ischemic Conditioning Strategies.

    Science.gov (United States)

    Kierulf-Lassen, Casper; Nieuwenhuijs-Moeke, Gertrude J; Krogstrup, Nicoline V; Oltean, Mihai; Jespersen, Bente; Dor, Frank J M F

    2015-01-01

    Ischemia-reperfusion injury is the leading cause of acute kidney injury in a variety of clinical settings such as renal transplantation and hypovolemic and/or septic shock. Strategies to reduce ischemia-reperfusion injury are obviously clinically relevant. Ischemic conditioning is an inherent part of the renal defense mechanism against ischemia and can be triggered by short periods of intermittent ischemia and reperfusion. Understanding the signaling transduction pathways of renal ischemic conditioning can promote further clinical translation and pharmacological advancements in this era. This review summarizes research on the molecular mechanisms underlying both local and remote ischemic pre-, per- and postconditioning of the kidney. The different types of conditioning strategies in the kidney recruit similar powerful pro-survival mechanisms. Likewise, renal ischemic conditioning mobilizes many of the same protective signaling pathways as in other organs, but differences are recognized. PMID:26330099

  2. Modifiable risk factors for ischemic stroke

    Directory of Open Access Journals (Sweden)

    Alexandros Gianoulakis

    2010-07-01

    Full Text Available Ischemic stroke is the third leading cause of death after cardiac disease and cancer in the developed countries. In patients older than 65 years old, ischemic stroke is one of the main causes of disability. They are also responsible for approximately 4.5 million deaths each year globally.The aim of the present study was to review the literature about the modifiable risk factors related to the development of ischemic stroke.The method οf this study included bibliographic research from both reviews and researches from literature, mainly of the last 8 years. The words used in pub med data base, referred to the modifiable risk factors related to the development of ischemic stroke.Results: In the majority of research studies, responsible risk factors for ischemic stroke are classified according to their ability of modification, in modifiable and non–modifiable risk factors. Some of the modifiable risk factors have been fully documented whereas some others need further research. The main modifiable risk factor is hypertension because on the one hand it promotes atherosclerosis and, on the other hand, leads to deteriorative changes and constrictions of small brain vessels. Atrial fibrillation is the most significant risk factor for ischemic stroke, since it is responsible for more than 50% of thromboembolic cases. Also, patients with diabetes mellitus are in higher risk for developing ischemic stroke compared to healthy population, whereas the danger is increasing in insuline-depented individuals. Increase of lipids in blood and disorders of cholesterol are responsible for atherosclerosis in coronary vessels and carotid. More in detail, carotid stenosis >50% in individuals over than 65 years old consist a significant risk factor for ischemic stroke. Though, the relation of smoking to ischemic stroke is still not fully understood, however smokers are in high risk for developing ischemic stroke for the reason that smoking is significantly related to

  3. Hypothermia for hypoxic–ischemic encephalopathy

    OpenAIRE

    Cotten, C. Michael; Shankaran, Seetha

    2010-01-01

    Moderate to severe hypoxic–ischemic injury in newborn infants, manifested as encephalopathy immediately or within hours after birth, is associated with a high risk of either death or a lifetime with disability. In recent multicenter clinical trials, hypothermia initiated within the first 6 postnatal hours has emerged as a therapy that reduces the risk of death or impairment among infants with hypoxic–ischemic encephalopathy. Prior to hypothermia, no therapies directly targeting neonatal encep...

  4. Constitutively Expressed αB—Crystallin in Heat Schock Transcription Factor 1 Knockout Mice Myocardium

    Institute of Scientific and Technical Information of China (English)

    刘莉; 张洪慧; 丁国宪; 程蕴琳; 晏良军; BENJAMINIvorJ

    2003-01-01

    Objective:To invesligate the effects of heat shock transcription factor 1(HSF 1) gene on the constitutively expressed aB-Crystallin(αBC)in mice myocardium.Methods:The expression levels of constitutive αBC in HSF1 knockout(hsf1-/-) and HSF1 wild type (hsf1+/+) mice myocardium were evaluated by western blot and immunohistochemistry.Results:The αBC levels in hsf1-/- and hsf1+/_ were 68.42±4.16,100.00±7.58,respectively(P<0.05,cytosolic fraction),and 20.53±1.01,37.55±1.91,respectively(P<0.05,pellet fraction).The αBC signals decreased significantly in hsf1-/- myocardium when compared with those in hsf1+/+ myocardium stained with fluorescence immunohistochemistry.Conclusion.HSF1 is an important,but not the only factor,which mediates the constitutively expressed αBC.

  5. Characterization of the positive and negative inotropic effects of acetylcholine in the human myocardium

    NARCIS (Netherlands)

    X.Y. Du (Xiaoyi); R.G. Schoemaker (Regien); E. Bos (Egbert); P.R. Saxena (Pramod Ranjan)

    1995-01-01

    textabstractIn the human isolated myocardium, acetylcholine (10−9 to 10−3 M) elicited a biphasic inotropic effect (a decrease in the lower and an increase in the higher concentration range) in atrial and a positive inotropic effect in ventricular trabeculae. However, under conditions of raised contr

  6. Impaired endothelium-dependent vasodilation of coronary resistance vessels in severely stunned porcine myocardium

    NARCIS (Netherlands)

    E.O. McFalls (Edward); D.J.G.M. Duncker (Dirk); H.B. Ward (Herbert B.); P. Fashingbauer (P.)

    1995-01-01

    textabstractThe effect of stunning on endothelium-dependent responses of resistance vessels in vivo remains of interest. We utilized the coronary pressure-flow relationship during maximal vasodilation in anesthetized swine to identify subtle changes in flow reserve within stunned myocardium. Prior t

  7. Influence of skeletal muscle satellite cells implanted into infarcted myocardium on remnant myocyte volumes

    Institute of Scientific and Technical Information of China (English)

    钟竑; 朱洪生; 卫洪超; 张臻

    2003-01-01

    Objective To study the effects of skeletal muscle satellite cells implanted into infarcted myocardium on the volume of remnant myocytes.Methods Thirty-six adult mongrel canines were divided randomly into implantation group and control group. In the implantation group, skeletal muscle satellite cells taken from the gluteus maximus muscles of the dogs were cultured, proliferated and labeled with 4', 6-diamidino-2-phenylindone (DAPI) in vitro. In both groups, a model of acute myocardial infarction was established in every dog. In the implantation group, each dog was injected with M199 solution containing autologous skeletal muscle satellite cells. The dogs in the control group received M199 solution without skeletal muscle satellite cells. The dogs of both groups were killed 2, 4 and 8 weeks after implantation (six dogs in a separate group each time). Both infarcted myocardium and normal myocytes distal from the infracted regions isolated were observed under optical and fluorescent microscope. Their volumes were determined using a confocal microscopy image analysis system and analyzed using SAS. A P<0.05 was considered significant.Results A portion of the implanted cells differentiated into muscle fiber with striations and were connected with intercalated discs. Cross-sectional area and cell volume were increased in normal myocardium. Hypertrophy of remnant myocytes in the infarcted site after skeletal muscle cell implantation was much more evident than in the control group. Cross-sectional area, cell area and cell volume differed significantly from those of the control group (P< 0.05). Hypertrophy of the cells occurred predominantly in terms of width and thickness, whereas cell length remained unchanged. Conclusion Skeletal muscle satellite cells implanted into infarct myocardium, could induce the hypertrophy of remnant myocyte cells in the infarcted site and could also aid in the recovery of the contractile force of the infarcted myocardium.

  8. Low-power Helium-Neon laser irradiation enhances the expression of VEGF in murine myocardium

    Institute of Scientific and Technical Information of China (English)

    张卫光; 吴长燕; 潘文潇; 田珑; 夏家骝

    2004-01-01

    Background Low-power helium-neon (He-Ne) lasers have been increasingly widely applied in the treatment of cardiovascular diseases, and its vasodilation effect has been proven. The aim of this study was to determine the effects of low-power He-Ne laser irradiation directed at the precardial region of Wistar rats on capillary permeability in the myocardium and the expression of myocardial vascular endothelial growth factor (VEGF). Methods Sixteen rats were divided randomly into control and irradiated groups (n=8, each). A He-Ne laser (632.8 nm) was applied to the irradiated group with a dose of 60.5 J/cm2. Ferritin was perfused into the left femoral vein and capillary permeability was examined under an electron microscope. VEGF expression in the myocardium was investigated by immunohistochemical methods, RT-PCR, and image analysis. Results The ultrastructures of the myocardial capillaries were examined. Compared to the control group, more high-density granules (ferritin), which were present within the capillary endothelium and the mitochondrions of myocardial cells in the internal layer of the myocardium, were observed in the irradiated group. VEGF staining of the myocardium was stronger in the irradiated group than that in the control group. The optic density of the irradiated group (0.246±0.015) was significantly higher than that of the control group (0.218±0.012, P<0.05). Finally, the levels of RT-PCR products of VEGF165 mRNA were 2.79 times higher in irradiated rats than in the control rats.Conclusions Our study demonstrates that He-Ne laser irradiation (in doses of 60.5 J/cm2) increases myocardial capillary permeability and the production of VEGF in myocardial microvessels and in myocardium. Our study provides experimental morphological evidence that myocardial microcirculation can be improved using He-Ne laser irradiation.

  9. Decline of Phosphotransfer and Substrate Supply Metabolic Circuits Hinders ATP Cycling in Aging Myocardium.

    Directory of Open Access Journals (Sweden)

    Emirhan Nemutlu

    Full Text Available Integration of mitochondria with cytosolic ATP-consuming/ATP-sensing and substrate supply processes is critical for muscle bioenergetics and electrical activity. Whether age-dependent muscle weakness and increased electrical instability depends on perturbations in cellular energetic circuits is unknown. To define energetic remodeling of aged atrial myocardium we tracked dynamics of ATP synthesis-utilization, substrate supply, and phosphotransfer circuits through adenylate kinase (AK, creatine kinase (CK, and glycolytic/glycogenolytic pathways using 18O stable isotope-based phosphometabolomic technology. Samples of intact atrial myocardium from adult and aged rats were subjected to 18O-labeling procedure at resting basal state, and analyzed using the 18O-assisted HPLC-GC/MS technique. Characteristics for aging atria were lower inorganic phosphate Pi[18O], γ-ATP[18O], β-ADP[18O], and creatine phosphate CrP[18O] 18O-labeling rates indicating diminished ATP utilization-synthesis and AK and CK phosphotransfer fluxes. Shift in dynamics of glycolytic phosphotransfer was reflected in the diminished G6P[18O] turnover with relatively constant glycogenolytic flux or G1P[18O] 18O-labeling. Labeling of G3P[18O], an indicator of G3P-shuttle activity and substrate supply to mitochondria, was depressed in aged myocardium. Aged atrial myocardium displayed reduced incorporation of 18O into second (18O2, third (18O3, and fourth (18O4 positions of Pi[18O] and a lower Pi[18O]/γ-ATP[18 O]-labeling ratio, indicating delayed energetic communication and ATP cycling between mitochondria and cellular ATPases. Adrenergic stress alleviated diminished CK flux, AK catalyzed β-ATP turnover and energetic communication in aging atria. Thus, 18O-assisted phosphometabolomics uncovered simultaneous phosphotransfer through AK, CK, and glycolytic pathways and G3P substrate shuttle deficits hindering energetic communication and ATP cycling, which may underlie energetic

  10. Prolonged multifocal electroretinographic implicit times in the ocular ischemic syndrome

    DEFF Research Database (Denmark)

    Kofoed, Peter Kristian; Munch, Inger Christine; Sander, Birgit;

    2010-01-01

    Purpose. To examine retinal function in chronic ocular ischemia using multifocal electroretinography (mfERG). Methods. Thirteen patients with unilateral ocular ischemic syndrome (OIS) underwent assessment of ophthalmic systolic blood pressure by ocular pneumoplethysmography, carotid artery patency.......4 +/- 1.7 mm Hg, respectively. Summed mfERG implicit times (N1, P1, N2) were prolonged in eyes with OIS, by 7.6%, 6.2%, and 7.5%, respectively, compared with fellow eyes (P ... the central retina was limited by high variance. Second-order kernel (first slice) summed implicit times (N1, P1, N2) were also prolonged in OIS, by 6.6%, 7.3%, and 6.8%, respectively (P

  11. COMPARACIÓN DE ESTRATEGIAS TERAPÉUTICAS PARA EL CONTROL DE LA TENSIÓN ARTERIAL Y LA ANGINA DE PECHO EN PACIENTES CON HIPERTENSIÓN ARTERIAL Y CARDIOPATÍA ISQUÉMICA CRÓNICA EN LA PROVINCIA DE VILLA CLARA. APÉNDICE DEL ESTUDIO INVEST / Comparison of therapeutic strategies for the control of blood pressure and angina in patients with hypertension and chronic ischemic heart disease in the province of Villa Clara. Appendix of INVEST study

    Directory of Open Access Journals (Sweden)

    Omaida J. López Bernal

    2011-06-01

    Full Text Available Background and Objectives: The treatment of hypertension and its complications are a worldwide problem. In our country nearly 25 % of the population over 15 years old is hypertensive, and this figure nearly doubles in those over 60. This research aims to compare two treatment strategies for controlling hypertension in outpatients with chronic coronary ischemic syndrome. Method: A total of 150 patients was included, 73 were randomized to receive calcium antagonist and non-calcium antagonist respectively, as 4 patients were subsequently excluded. Each was asked to sign consent, underwent clinical examination and a 12-lead, conventional electrocardiogram. Blood pressure and episodes of angina were evaluated at 6 months and one year. All variables were entered into a database and statistical analysis was performed using Student's t and Chi square. Results: The mean age was 61,5 years. Women and white skin color were predominant. At 12 months of treatment, blood pressure normalized in more than 80 % of patients without significant differences between the two treatment strategies. Over 75 % of patients in both groups controlled the angina episodes and more than 85 % said the quality of life was good. Conclusions: Control of blood pressure and angina was achieved and there were no significant differences between the two treatment strategies.

  12. Occurrence and predictors of persistent impaired glucose tolerance after acute ischemic stroke or transient ischemic attack

    NARCIS (Netherlands)

    S. Fonville (Susanne); H.M. den Hertog (Heleen); A.A.M. Zandbergen (Adrienne); P.J. Koudstaal (Peter Jan); H.F. Lingsma (Hester)

    2014-01-01

    textabstractBackground Impaired glucose tolerance is often present in patients with a transient ischemic attack (TIA) or ischemic stroke and doubles the risk of recurrent stroke. This impaired glucose tolerance can be transient, reflecting an acute stress response, or persistent, representing undiag

  13. Quantitative Measurement of Physical Activity in Acute Ischemic Stroke and Transient Ischemic Attack

    DEFF Research Database (Denmark)

    Strømmen, Anna Maria; Christensen, Thomas; Jensen, Kai

    2014-01-01

    BACKGROUND AND PURPOSE: The purpose of this study was to quantitatively measure and describe the amount and pattern of physical activity in patients within the first week after acute ischemic stroke and transient ischemic attack using accelerometers. METHODS: A total of 100 patients with acute...... ischemic stroke or transient ischemic attack admitted to our acute stroke unit wore Actical accelerometers attached to both wrists and ankles and the hip for ≤7 days. Patients were included within 72 hours of symptom onset. Accelerometer output was measured in activity counts (AC). Patients were tested...... daily with Scandinavian Stroke Scale. RESULTS: Physical activity peaked in the morning and declined during the rest of the day. In patients with stroke, total AC were 71% lower than in patients with transient ischemic attack. AC were 80% lower in the paretic compared with those in the nonparetic arm...

  14. Free radical scavenger, edaravone, reduces the lesion size of lacunar infarction in human brain ischemic stroke

    Science.gov (United States)

    2011-01-01

    Background Although free radicals have been reported to play a role in the expansion of ischemic brain lesions, the effect of free radical scavengers is still under debate. In this study, the temporal profile of ischemic stroke lesion sizes was assessed for more than one year to evaluate the effect of edaravone which might reduce ischemic damage. Methods We sequentially enrolled acute ischemic stroke patients, who admitted between April 2003 and March 2004, into the edaravone(-) group (n = 83) and, who admitted between April 2004 and March 2005, into the edaravone(+) group (n = 93). Because, edaravone has been used as the standard treatment after April 2004 in our hospital. To assess the temporal profile of the stroke lesion size, the ratio of the area [T2-weighted magnetic resonance images (T2WI)/iffusion-weighted magnetic resonance images (DWI)] were calculated. Observations on T2WI were continued beyond one year, and observational times were classified into subacute (1-2 months after the onset), early chronic (3-6 month), late chronic (7-12 months) and old (≥13 months) stages. Neurological deficits were assessed by the National Institutes of Health Stroke Scale upon admission and at discharge and by the modified Rankin Scale at 1 year following stroke onset. Results Stroke lesion size was significantly attenuated in the edaravone(+) group compared with the edaravone(-) group in the period of early and late chronic observational stages. However, this reduction in lesion size was significant within a year and only for the small-vessel occlusion stroke patients treated with edaravone. Moreover, patients with small-vessel occlusion strokes that were treated with edaravone showed significant neurological improvement during their hospital stay, although there were no significant differences in outcome one year after the stroke. Conclusion Edaravone treatment reduced the volume of the infarct and improved neurological deficits during the subacute period, especially

  15. Mobilization of bone marrow stem cells by G-CSF in patients with chronic ischemic heart disease after revascularization%骨髓干细胞动员结合冠状动脉介入在慢性缺血性心脏病患者中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    郭士遵; 王宁夫; 叶显华; 周亮; 潘浩; 李虹; 童国新

    2014-01-01

    目的:探究骨髓干细胞动员结合冠状动脉介入(PCI)治疗对慢性缺血性心脏病患者心功能的影响及其安全性。方法收集41例合并有粒细胞减少的慢性缺血性心脏病患者。随机将患者分入对照组和粒细胞集落刺激因子(G- CSF)组。在规范药物治疗和成功进行PCI治疗基础上,G- CSF组接受G- CSF皮下注射。住院及随访期间进行血液学检查、超声心动图检查并进行6min步行试验。结果治疗前两组基线资料、冠状动脉造影以及PCI相关参数差异均无统计学意义(均P>0.05)。在6个月随访时,两组患者缺血节段室壁增厚率、LVEF均较治疗前增加,而Tei指数较治疗前降低(均P<0.05);两组室壁运动评分指数均在随访时得到改善,但与治疗前比较差异无统计学意义,随访变化值差异亦无统计学意义(均P>0.05)。6个月随访时两组LVEDV、Tei指数差异有统计学意义,随访变化值差异亦有统计学意义(均P<0.05)。两组患者6min步行距离的随访变化值无统计学意义(P>0.05)。住院及随访期间两组患者均未出现严重不良心脏事件。结论对慢性缺血性心脏病患者在成功地进行PCI治疗后利用G- CSF进行干细胞动员是安全的,对心功能的改善有一定的积极作用。%Objective To evaluate the efficacy of bone marrow stem cellmobilization by G- CSF in patients with chronic ischemic heart disease (CIHD) after revascularization. Methods Forty one patients with CIHD and granulopenia who had suc-cessful fractional Percutaneous coronary intervention (PCI) were included in the study. Patients were randomized into G- CSF group (G- CSF10μg/kg for 7d) and control group (no G- CSF was given). Patients were fol owed up for 6 months. Results De-mographics, clinical characteristics, and parameter of CAG and PCI were homogeneous between two groups (P>0.05). The wal thickening in severe impaired segment

  16. Caffeine prevents protection in two human models of ischemic preconditioning.

    NARCIS (Netherlands)

    Riksen, N.P.; Zhou, Z.; Oyen, W.J.G.; Jaspers, R.A.; Ramakers, B.P.; Brouwer, R.M.H.J.; Boerman, O.C.; Steinmetz, N.; Smits, P.; Rongen, G.A.

    2006-01-01

    OBJECTIVES: We studied whether caffeine impairs protection by ischemic preconditioning (IP) in humans. BACKGROUND: Ischemic preconditioning is critically dependent on adenosine receptor stimulation. We hypothesize that the adenosine receptor antagonist caffeine blocks the protective effect of IP. ME

  17. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies.

    NARCIS (Netherlands)

    Detaille, S.I.; Heerkens, Y.F.; Engels, J.A.; Gulden, J.W.J. van der; Dijk, F.J. van

    2009-01-01

    OBJECTIVE: Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD

  18. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies

    NARCIS (Netherlands)

    S.I. Detaille; Y.F. Heerkens; J.A. Engels; J.W.J. van der Gulden; F.J.H. van Dijk

    2009-01-01

    Objective Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD)

  19. Pre-ischemic exercise alleviates oxidative damage following ischemic stroke in rats.

    Science.gov (United States)

    Feng, Rui; Zhang, Min; Wang, Xiao; Li, Wen-Bin; Ren, Shi-Qing; Zhang, Feng

    2014-10-01

    Physical exercise has been proved to be neuroprotective in clinical trials and animal experiments. However, the exact mechanism underlying this neuroprotective effect remains unclear. The aim of the present study was to explore whether pre-ischemic treadmill training could act as a form of ischemic preconditioning in a rat following ischemic stroke by reducing oxidative damage. Fifty-four rats were randomly divided into three groups (n=18 per group): Sham surgery, middle cerebral artery occlusion (MCAO) without exercise and MCAO with exercise. Subsequent to treadmill training, ischemic stroke was induced by occluding the MCA for 1.5 h, followed by reperfusion. Six rats in each group were evaluated for neurological deficits and then sacrificed by decapitation to calculate the infarct volume. The remaining rats in each group were sacrificed to detect the level of superoxide dismutase (SOD) activity (n=6) and malondialdehyde (MDA) concentration (n=6). The results indicated that pre-ischemic exercise training reduced brain infarct volume and neurological deficits, increased SOD activity and decreased the concentration of MDA following ischemic stroke. In conclusion, treadmill exercise training prior to MCAO/reperfusion increased the antioxidant ability and decreased the oxidative damage in the brain subsequent to ischemic stroke. PMID:25187848

  20. Chemokine stromal cell-derived factor 1/CXCL12 increases homing of mesenchymal stem cells to injured myocardium and neovascularization following myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    ZHUANG Yu; CHEN Xin; XU Ming; ZHANG Lei-yang; XIANG Fei

    2009-01-01

    Background Heart failure due to ischemic heart disease is still a major health problem. Myocardium regeneration emerges as a novel therapeutic method for treating myocardial infarction (MI). However, it is affected by many factors. The present study was aimed to investigate the effect of chemokine stromal cell-derived factor 1 (SDF-1)/CXCL12 on mesenchymal stem cells (MSCs) homing to injured myocardium in a rat myocardial infarction model. Methods A rat myocardial infarction model was established by permanent left anterior descending branch ligation. Mesenchymal stem cells from donor rats were cultured in IMDM and labeled with bromodeoxyuridine. The rats were divided into two groups. SDF-1 expression was measured by in situ hybridization and immunohistochemistry in the sham operated or infarcted hearts at 1, 2, 4, 7, 14 and 28 days post operation in the SDF-1 detection group. The rats in the intervention groups were injected with SDF-1, anti-SDF-1 antibody or saline 4 days after myocardial infarction. Then, a total of 5x106 cells in 2.5 ml of phosphate-buffered saline were injected through the tail vein. The number of the labeled MSCs in the infarcted hearts was counted on the 3rd clay post injection. Cardiac function and blood vessel density were assessed on the 28th day post injection. Results Self-generating SDF-1 expression was increased at the first day post MI, peaked at the 7th day and decreased thereafter while it remained unchanged in sham operated hearts. The MSCs enrichment in the host hearts were more abundant in the MI groups than in the non-MI group (P=0.000); the MSCs enrichment in the host hearts were more abundant in the SDF-1 injected group than in the anti-SDF-1 antibody and saline injected groups (P = 0.000). Cardiac function was improved more in the SDF-1 injected group than in the anti-SDF-1 antibody and saline injected groups (P = 0.000). Neovascularization in the SDF-1 injected group increased significantly compared to the other groups (P

  1. Cardiac magnetic resonance determinants of functional mitral regurgitation in ischemic and non ischemic left ventricular dysfunction.

    Science.gov (United States)

    Fernández-Golfín, Covadonga; De Agustin, Alberto; Manzano, M Carmen; Bustos, Ana; Sánchez, Tibisay; Pérez de Isla, Leopoldo; Fuentes, Manuel; Macaya, Carlos; Zamorano, José

    2011-04-01

    Functional mitral regurgitation (FMR) is frequent in left ventricular (LV) dilatation/dysfunction. Echocardiographic predictors of FMR are known. However, cardiac magnetic resonance (CMR) predictors of FMR have not been fully addressed. The aim of the study was to evaluate CMR mitral valve (MV) parameters associated with FMR in ischemic and non ischemic LV dysfunction. 80 patients with LV ejection fraction below 45% and/or left ventricular dilatation of ischemic and non ischemic etiology were included. Cine-MR images (steady state free-precession) were acquired in a short-axis and 4 chambers views where MV evaluation was performed. Delayed enhancement was performed as well. Significant FMR was established as more than mild MR according to the echocardiographic report. Mean age was 59 years, males 79%. FMR was detected in 20 patients (25%) Significant differences were noted in LV functional parameters and in most MV parameters according to the presence of significant FMR. However, differences were noted between ischemic and non ischemic groups. In the first, differences in most MV parameters remained significant while in the non ischemic, only systolic and diastolic interpapillary muscle distance (1.60 vs. 2.19 cm, P = 0.001; 2. 51 vs. 3.04, P = 0.008) were predictors of FMR. FMR is associated with a more severe LV dilatation/dysfunction in the overall population. CMR MV parameters are associated with the presence of significant FMR and are different between ischemic and non ischemic patients. CMR evaluation of these patients may help in risk stratification as well as in surgical candidate selection.

  2. Cerebrovascular arteriopathy (arteriosclerosis) and ischemic childhood stroke.

    Science.gov (United States)

    Daniels, S R; Bates, S; Lukin, R R; Benton, C; Third, J; Glueck, C J

    1982-01-01

    The aim of this report is to describe the intracranial cerebrovascular abnormalities and clinical status of 8 children who had familial lipoprotein disorders and evidence of thromboembolic cerebrovascular disease. Six of the 8 children had low levels of plasma high density lipoprotein cholesterol, two had high triglyceride levels, and all came from kindreds characterized by familial lipoprotein abnormalities and premature cardio- and/or cerebrovascular atherosclerosis. Vascular occlusion, irregularities of the arterial lumen, beading, tortuosity, and evidence of collateralization were consistently noted. We speculate that cerebrovascular arteriosclerosis in pediatric ischemic stroke victims who have familial lipoprotein abnormalities may be related to lipoprotein-mediated endothelial damage and thrombosis formation, or to the failure to restore endothelial cells' integrity following damage. The apparent association of lipoproteins and strokes in children and their families merits further exploration, particularly when assessing cerebral angiograms in pediatric ischemic stroke victims. In children with unexplained ischemic cerebrovascular accidents, the diagnostic possibility of occlusive arteriosclerosis with thrombosis must be entertained.

  3. Spectroscopic Monitoring of Kidney Tissue Ischemic Injury

    Energy Technology Data Exchange (ETDEWEB)

    Demos, S G; Fitzgerald, J T; Michalopoulou, A P; Troppmann, C

    2004-03-11

    Noninvasive evaluation of tissue viability of donor kidneys used for transplantation is an issue that current technology is not able to address. In this work, we explore optical spectroscopy for its potential to assess the degree of ischemic damage in kidney tissue. We hypothesized that ischemic damage to kidney tissue will give rise to changes in its optical properties which in turn may be used to asses the degree of tissue injury. The experimental results demonstrate that the autofluorescence intensity of the injured kidney is decreasing as a function of time exposed to ischemic injury. Changes were also observed in the NIR light scattering intensities most probably arising from changes due to injury and death of the tissue.

  4. Digital Ischemic Loss in Systemic Sclerosis

    Directory of Open Access Journals (Sweden)

    Umaima Marvi

    2010-01-01

    Full Text Available Digital ischemic loss is a cause of significant morbidity in patients with systemic sclerosis (SSc. Microvascular disease with intimal proliferation and luminal narrowing of small digital arteries, as well as macrovascular disease with narrowing or occlusion of larger digital arteries, contribute to the perfusion defects involved in digital ischemic loss. Immediate clinical evaluation and treatment are mandatory at the onset of critical digital ischemia to prevent digital loss. Hospitalization for medical therapies including intravenous prostacyclin therapy should be considered for all SSc patients who present with critical digital ischemia. Surgical interventions are typically reserved for patients who fail medical therapies and for those with late stage, necrotic tissue. This paper summarizes the current knowledge regarding the risk factors, pathogenesis, evaluation, and treatment of digital ischemic loss in SSc.

  5. [Nonfasting triglycerides and risk of ischemic stroke--secondary publication

    DEFF Research Database (Denmark)

    Freiberg, J.J.; Tybjaerg-Hansen, A.; Jensen, J.S.;

    2009-01-01

    The role of triglycerides in the risk of ischemic stroke remains controversial. We tested the hypothesis that increased levels of nonfasting triglycerides are associated with ischemic stroke in the general population. Men with a nonfasting triglyceride level 5 mmol/l had a multivariable, adjusted...... hazard ratio for ischemic stroke of 2.5 (95% confidence interval: 1.3-4.8) compared with men with a nonfasting triglyceride level triglycerides is associated with risk of ischemic stroke Udgivelsesdato...

  6. Polymorphisms in apolipoprotein B and risk of ischemic stroke

    DEFF Research Database (Denmark)

    Benn, Marianne; Nordestgaard, Børge G; Jensen, Jan Skov;

    2007-01-01

    Apolipoprotein B levels associate with risk of ischemic stroke. APOB polymorphisms may influence levels of apolipoprotein B and low-density lipoprotein (LDL), but whether they associate with risk of ischemic stroke is unknown.......Apolipoprotein B levels associate with risk of ischemic stroke. APOB polymorphisms may influence levels of apolipoprotein B and low-density lipoprotein (LDL), but whether they associate with risk of ischemic stroke is unknown....

  7. Segmentation of scarred and non-scarred myocardium in LG enhanced CMR images using intensity-based textural analysis.

    Science.gov (United States)

    Kotu, Lasya Priya; Engan, Kjersti; Eftestøl, Trygve; Ørn, Stein; Woie, Leik

    2011-01-01

    The Late Gadolinium (LG) enhancement in Cardiac Magnetic Resonance (CMR) imaging is used to increase the intensity of scarred area in myocardium for thorough examination. Automatic segmentation of scar is important because scar size is largely responsible in changing the size, shape and functioning of left ventricle and it is a preliminary step required in exploring the information present in scar. We have proposed a new technique to segment scar (infarct region) from non-scarred myocardium using intensity-based texture analysis. Our new technique uses dictionary-based texture features and dc-values to segment scarred and non-scarred myocardium using Maximum Likelihood Estimator (MLE) based Bayes classification. Texture analysis aided with intensity values gives better segmentation of scar from myocardium with high sensitivity and specificity values in comparison to manual segmentation by expert cardiologists.

  8. Characterization of the functional and anatomical differences in the atrial and ventricular myocardium from three species of elasmobranch fishes

    DEFF Research Database (Denmark)

    Larsen, Julie; Bushnell, Peter; Steffensen, John;

    2016-01-01

    We assessed the functional properties in atrial and ventricular myocardium (using isolated cardiac strips) of smooth dogfish (Mustelus canis), clearnose skate (Raja eglanteria), and sandbar shark (Carcharhinus plumbeus) by blocking Ca(2+) release from the sarcoplasmic reticulum (SR) with ryanodin...

  9. A structurally based viscoelastic model for passive myocardium in finite deformation

    Science.gov (United States)

    Shen, Jing Jin

    2016-09-01

    This paper discusses the finite-deformation viscoelastic modeling for passive myocardium tissue. The formulations established can also be applied to model other fiber-reinforced soft tissue. Based on the morphological structure of the myocardium, a specific free-energy function is constructed to reflect its orthotropicity. After deriving the stress-strain relationships in the simple shear deformation, a genetic algorithm is used to optimally estimate the material parameters of the myocardial constitutive equation. The results show that the proposed myocardial model can well fit the shear experimental data. To validate the viscoelastic model, it is used to predict the creep and the dynamic responses of a cylindrical model of the left ventricle. Upon comparing the results calculated by the proven myocardial elastic model with those by the viscoelastic model, the merits of the latter are discussed.

  10. Enhanced infarct myocardium repair mediated by thermosensitive copolymer hydrogel-based stem cell transplantation

    Science.gov (United States)

    Xia, Yu; Zhu, Kai; Lai, Hao; Lang, Meidong; Xiao, Yan; Lian, Sheng

    2015-01-01

    Mesenchymal stem cell (MSC) transplantation by intramyocardial injection has been proposed as a promising therapy strategy for cardiac repair after myocardium infarction. However, low retention and survival of grafted MSCs hinder its further application. In this study, copolymer with N-isopropylacrylamide/acrylic acid/2-hydroxylethyl methacrylate-poly(ɛ-caprolactone) ratio of 88:9.6:2.4 was bioconjugated with type I collagen to construct a novel injectable thermosensitive hydrogel. The injectable and biocompatible hydrogel-mediated MSC transplantation could enhance the grafted cell survival in the myocardium, which contributed to the increased neovascularization, decreased interstitial fibrosis, and ultimately improved heart function to a significantly greater degree than regular MSC transplantation. We suggest that this novel hydrogel has the potential for future stem cell transplantation. PMID:25432986

  11. Second harmonic generation imaging of the collagen in myocardium for atrial fibrillation diagnosis

    Science.gov (United States)

    Tsai, Ming-Rung; Chiou, Yu-We; Sun, Chi-Kuang

    2009-02-01

    Myocardial fibrosis, a common sequela of cardiac hypertrophy, has been shown to be associated with arrhythmias in experimental models. Some research has indicated that myocardial fibrosis plays an important role in predisposing patients to atrial fibrillation. Second harmonic generation (SHG) is an optically nonlinear coherent process to image the collagen network. In this presentation, we observe the SHG images of the collagen matrix in atrial myocardium and we analyzed of collagen fibers arrangement by using Fourier-transform analysis. Moreover, comparing the SHG images of the collagen fibers in atrial myocardium between normal sinus rhythm (NSR) and atrial fibrillation (AF), our result indicated that it is possible to realize the relation between myocardial fibrosis and AF.

  12. Ultrastructural Study of Moniliformin Induced Lesions of Myocardium in Rats and Mice

    Institute of Scientific and Technical Information of China (English)

    ZhaoDeyu; FengQl; 等

    1993-01-01

    Effects of moliliformin on the ultrastructure of the myocardium of mice and rats were studies.Mice were given moniliformin orally at a dose of 29.46mg·kg-1 the LD50.One h after dosing,lesions of the mitochondria of the myocardial cells were found which became more severe in 2 and 3 h.Ultrastructrual olesions were also observed in the myofibrils and sarcolemma.Rats were given moniliformin orally at the dosage of 6mg·kg-1 once daily for 56d.Lesions of mitochondria and myofibrils were relatively mild.In the myocardiac specimens taken from the 21d post-toxin administration,lesions of the sarcolemma became more obvious.These moniliformin-induced lesions were simillar to the ultrastructural changes in the myocardium of patients with Keshan disease.Our findings indicate that there may be a close and important relationship between moniliformin intoxication and Keshan disease.

  13. Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study.

    Directory of Open Access Journals (Sweden)

    Jen-Yu Wang

    Full Text Available BACKGROUND: Although much attention has been focused on the association between chronic hyperglycemia and cerebrovascular diseases in type 2 diabetes mellitus (DM patients, there is no data regarding the risk of ischemic stroke after a hyperosmolar hyperglycemic state (HHS attack. The objective of this study was to investigate the risk of ischemic stroke in type 2 DM patients after an HHS attack. METHODS: From 2004 to 2008, this retrospective observational study was conducted on a large cohort of Taiwanese using Taiwan's National Health Insurance Research Database (NHIRD. We identified 19,031 type 2 DM patients who were discharged with a diagnosis of HHS and 521,229 type 2 DM patients without an HHS diagnosis. Using the propensity score generated from logistic regression models, conditional on baseline covariates, we matched 19,031 type 2 DM patients with an HHS diagnosis with the same number from the comparison cohort. The one-year cumulative rate for ischemic stroke was estimated using the Kaplan-Meier method. After adjusting covariates, Cox proportional hazard regression was used to compute the adjusted one-year rate of ischemic stroke. RESULTS: Of the patients sampled, 1,810 (9.5% of the type 2 DM patients with HHS and 996 (5.2% of the comparison cohort developed ischemic stroke during the one-year follow-up period. After adjusting for covariates, the adjusted HR for developing ischemic stroke during the one-year follow-up period was 1.8 (95% C.I., 1.67 to 1.95, P<0.001 for type 2 DM patients with HHS compared with those without HHS. CONCLUSION: Although DM is a well-recognized risk factor for atherosclerosis, type 2 DM patients that have suffered a HHS attacks are at an increased risk of developing ischemic stroke compared with those without HHS.

  14. Evaluation of thyroid hormone induced pharmacological preconditioning on cardiomyocyte protection against ischemic-reperfusion injury

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2012-01-01

    Full Text Available Objectives: Ischemic preconditioning (IPC has been demonstrated to make myocardium transiently more resistant to deleterious effect of prolonged ischemia. The opening of the mitochondrial permeability transition pore (mPTP at the time of myocardial reperfusion is a critical determinant of cell death. L-thyroxine pre-treatment increases the tolerance of the heart to ischemia and produces cardioprotection similar to ischemic precondition. This study has been designed to investigate the mechanism involved in L-thyroxine-induced cardiomyocyte protection against ischemia-reperfusion (I/R injury in rats. Materials and Methods: L-thyroxine (T 4 was administered to Wistar rats (n=6 (25 μg/100 g/day s.c. for two weeks. Hearts from normal and L-thyroxine-treated rats were perfused in Langendorff′s mode and subjected to 30 min of ischemia followed by 120 min of reperfusion. Myocardial infarct size was estimated by triphenyltetrazolium chloride (TTC staining and lactate dehydrogenase (LDH and creatine kinase-MB (CK-MB was analyzed in coronary effluent. Results: IPC and pharmacological preconditioning (PPC significantly decreased (P<0.05 myocardial infarct size, release of LDH and CK-MB in rat heart. Perfusion of atractyloside, an opener of mPTP, significantly (P<0.05 attenuated the cardioprotective effect of IPC and L-thyroxine-induced pharmacological preconditioning (PPC in normal rat heart. Conclusion: The cardioprotective effect of L-thyroxine-induced preconditioning may be mediated through inhibition of mPTP opening during reperfusion phase.

  15. Decrease in the Sensitivity of Myocardium to M3 Muscarinic Receptor Stimulation during Postnatal Ontogenisis.

    Science.gov (United States)

    Tapilina, S V; Abramochkin, D V

    2016-01-01

    Type 3 muscarinic receptors (M3 receptors) participate in the mediation of cholinergic effects in mammalian myocardium, along with M2 receptors. However, myocardium of adult mammals demonstrates only modest electrophysiological effects in response to selective stimulation of M3 receptors which are hardly comparable to the effects produced by M2 stimulation. In the present study, the effects of selective M3 stimulation induced by application of the muscarinic agonist pilocarpine (10 μM) in the presence of the selective M2 blocker methoctramine (100 nM) on the action potential (AP) waveform were investigated in isolated atrial and ventricular preparations from newborn and 3-week-old rats and compared to those in preparations from adult rats. In the atrial myocardium, stimulation of M3 receptors produced a comparable reduction of AP duration in newborn and adult rats, while in 3-week-old rats the effect was negligible. In ventricular myocardial preparations from newborn rats, the effect of M3 stimulation was more than 3 times stronger compared to that from adult rats, while preparations from 3-week old rats demonstrated no definite effect, similarly to atrial preparations. In all studied types of cardiac preparations, the effects of M3 stimulation were eliminated by the selective M3 antagonist 4-DAMP (10 nM). The results of RT-PCR show that the amount of product of the M3 receptor gene decreases with the maturation of animals both in atrial and ventricular myocardium. We concluded that the contribution of M3 receptors to the mediation of cardiac cholinergic responses decreases during postnatal ontogenesis. These age-related changes may be associated with downregulation of M3 receptor gene expression. PMID:27437147

  16. Rapid T1 Mapping of Mouse Myocardium with Saturation Recovery Look-Locker Method

    OpenAIRE

    Li, Wen; Griswold, Mark; Yu, Xin

    2010-01-01

    Dynamic contrast enhanced MRI (DCE-MRI) using gadolinium or manganese provides unique characterization of myocardium and its pathology. In the current study, an ECG-triggered saturation recovery Look-Locker (SRLL) method was developed and validated for fast cardiac T1 mapping in small animal models. By sampling the initial portion of the longitudinal magnetization recovery curve, high temporal resolution (~3 min) can be achieved at a high spatial resolution (195×390 µm2) in mouse heart withou...

  17. Effects of myocardial infarction on the distribution and transport of nutrients and oxygen in porcine myocardium.

    Science.gov (United States)

    Davis, Bryce H; Morimoto, Yoshihisa; Sample, Chris; Olbrich, Kevin; Leddy, Holly A; Guilak, Farshid; Taylor, Doris A

    2012-10-01

    One of the primary limitations of cell therapy for myocardial infarction is the low survival of transplanted cells, with a loss of up to 80% of cells within 3 days of delivery. The aims of this study were to investigate the distribution of nutrients and oxygen in infarcted myocardium and to quantify how macromolecular transport properties might affect cell survival. Transmural myocardial infarction was created by controlled cryoablation in pigs. At 30 days post-infarction, oxygen and metabolite levels were measured in the peripheral skeletal muscle, normal myocardium, the infarct border zone, and the infarct interior. The diffusion coefficients of fluorescein or FITC-labeled dextran (0.3-70 kD) were measured in these tissues using fluorescence recovery after photobleaching. The vascular density was measured via endogenous alkaline phosphatase staining. To examine the influence of these infarct conditions on cells therapeutically used in vivo, skeletal myoblast survival and differentiation were studied in vitro under the oxygen and glucose concentrations measured in the infarct tissue. Glucose and oxygen concentrations, along with vascular density were significantly reduced in infarct when compared to the uninjured myocardium and infarct border zone, although the degree of decrease differed. The diffusivity of molecules smaller than 40 kD was significantly higher in infarct center and border zone as compared to uninjured heart. Skeletal myoblast differentiation and survival were decreased stepwise from control to hypoxia, starvation, and ischemia conditions. Although oxygen, glucose, and vascular density were significantly reduced in infarcted myocardium, the rate of macromolecular diffusion was significantly increased, suggesting that diffusive transport may not be inhibited in infarct tissue, and thus the supply of nutrients to transplanted cells may be possible. in vitro studies mimicking infarct conditions suggest that increasing nutrients available to

  18. Atorvastatin prevents connexin43 remodeling in hypertrophied left ventricular myocardium of spontaneously hypertensive rats

    Institute of Scientific and Technical Information of China (English)

    CHEN Hong-juan; YAO Lei; CHEN Tu-gang; YU Min; WANG Li-hong; CHEN Jun-zhu

    2007-01-01

    Background Connexin43 (Cx43) is the predominant gap junction protein in heart and is involved in the control of cell-to-cell communication to modulate the contractility and the electrical coupling of cardiac myocytes. Left ventricular(LV) hypertrophy is accompanied by changes of Cx43 expression. Recent studies have demonstrated that statins reduced cardiac hypertrophy. However, it is unknown whether statins can affect Cx43 expression in hypertrophied left ventricular myocardium. This study was designed to assess the effects of atorvastatin on LV hypertrophy and Cx43 expression in spontaneously hypertensive rats (SHR).Methods Nine-week old SHRs were randomly divided into two groups. Some received atorvastatin at 30 mg/kg by oral gavage once daily for 8 weeks (SHR-A); others received vehicle. Age-matched Wistar-Kyoto rats (WKY) received atorvastatin or vehicle for 8 weeks were used as controls. At the end of the experiment, we investigated LV hypertrophy and the expression of Cx43 in LV myocardium in four groups. Cx43 expression was investigated by the methods of Western blotting, immunohistochemistry, and transmission electron microscope. LV hypertrophy was accessed by pathological analysis and plasma brain natriuretic peptide (BNP) level.Results LV hypertrophy was prominent in untreated SHR. In SHR, LV myocardium Cx43 level was upregulated, and the distribution of Cx43 was displaced from their usual locations to other sites at various distances away from the intercalated disks. After atorvastatin treatment, myocardium Cx43 level was reduced in SHR-A, and the distribution of Cx43 gap junction became much regular and confined to intercalated disk. Statins also prevented LV hypertrophy in SHR.Conclusions These results provide novel in vivo evidence for the key role of Cx43 gap junctions in LV hypertrophy and the possible mechanism in anti-hypertrophic effect of statins. Atorvastatin treatment may have beneficial effects on LV hypertrophy in spontaneously hypertensive

  19. Wave propagation simulation in normal and infarcted myocardium: computational and modelling issues.

    Science.gov (United States)

    Maglaveras, N; Van Capelle, F J; De Bakker, J M

    1998-01-01

    Simulation of propagating action potentials (PAP) in normal and abnormal myocardium is used for the understanding of mechanisms responsible for eliciting dangerous arrhythmias. One- and two-dimensional models dealing with PAP properties are reviewed in this paper viewed both from the computational and mathematical aspects. These models are used for linking theoretical and experimental results. The discontinuous nature of the PAP is demonstrated through the combination of experimental and theoretically derived results. In particular it can be shown that for increased intracellular coupling resistance the PAP upstroke phase properties (Vmax, dV/dtmax and tau foot) change considerably, and in some cases non-monotonically with increased coupling resistance. It is shown that tau foot) is a parameter that is very sensitive to the cell's distance to the stimulus site, the stimulus strength and the coupling resistance. In particular it can be shown that in a one-dimensional structure the tau foot value can increase dramatically for lower coupling resistance values near the stimulus site and subsequently can be reduced as we move to distances larger than five resting length constants from the stimulus site. The tau foot variability is reduced with increased coupling resistance, rendering the lower coupling resistance structures, under abnormal excitation sequences, more vulnerable to conduction block and arrhythmias. Using the theory of discontinuous propagation of the PAP in the myocardium it is demonstrated that for specific abnormal situations in the myocardium, such as infarcted tissue, one- and two-dimensional models can reliably simulate propagation characteristics and explain complex phenomena such as propagation at bifurcation sites and mechanisms of block and re-entry. In conclusion it is shown that applied mathematics and informatics can help in elucidating electrophysiologically complex mechanisms such as arrhythmias and conduction disturbances in the myocardium

  20. Definition of morphological changes of hepar, myocardium and stomach cells in rats after carbamazepin and thyotriazolin administration

    Directory of Open Access Journals (Sweden)

    Opryshko V.I.

    2012-01-01

    Full Text Available We investigated the histological changes in rats after new complex drug administration. Seventy male white rats were used for this experiment. During 90 days they received carbamazepin and thyotriazolin compound. Compound were administered orally via gavage. We observed damaging action of high dose carbamazepin on hepar, myocardium and stomach. Our data suggest that thyotriazolin reduce toxic effect of carbamazepin on hepar, myocardium and stomach.

  1. Computer Aided Detection of Ischemic Stroke Using Verilog HDL

    OpenAIRE

    P. Arivalagan*1; K. Adalarasu2

    2014-01-01

    Computed tomography (CT) images are widely used in the diagnosis of ischemic stroke because of its faster acquisition and compatibility with most life support devices. In present work we proposal advance techniques to automated detection of ischemic stroke using verilog code and image feature characteristics, which separate the ischemic stroke region from healthy tissues in computed tomography images.

  2. Sonographic and Endoscopic Findings in Cocaine-Induced Ischemic Colitis

    DEFF Research Database (Denmark)

    Leth, Thomas; Wilkens, Rune; Bonderup, Ole Kristian

    2015-01-01

    Cocaine-induced ischemic colitis is a recognized entity. The diagnosis is based on clinical and endoscopic findings. However, diagnostic imaging is helpful in the evaluation of abdominal symptoms and prior studies have suggested specific sonographic findings in ischemic colitis. We report...... sonographic and endoscopic images along with abdominal computed tomography in a case of cocaine-induced ischemic colitis....

  3. The stem-cell application in ischemic heart disease: Basic principles, specifics and practical experience from clinical studies

    Directory of Open Access Journals (Sweden)

    Banović Marko

    2015-01-01

    Full Text Available Longer life duration, different clinical presentations of coronary disease, as well as high incidence of comorbidity in patients with ischemic heart disease have led to an increase in the incidence of ischemic heart failure. Despite numerous and new treatment methods that act on different pathophysiological mechanisms that cause heart failure, and whose aim is to slowdown or stop the progression of this devastating disease, morbidity and mortality in these patients remain high. These facts have firstly led to the introduction of the experimental, and then clinical studies with the application of stem cells in patients with ischemic heart disease. Previous studies have shown that the application of stem cells is a feasible and safe method in patients with acute coronary syndrome, as well as in patients with chronic ischemic cardiomyopathy, but the efficacy of these methods in both of the abovementioned clinical syndromes has yet to be established. This review paper outlines the basic principles of treatment of ischemic heart disease with stem cells, as well as the experience and knowledge gained in previous clinical studies.

  4. Features of metabolic disturbances in rat myocardium under effect of alternating magnetic fields of different parameters

    Energy Technology Data Exchange (ETDEWEB)

    Kolodub, F.A.; Chernysheva, O.N.; Yevtushenko, G.I.

    1981-04-01

    The high sensitivity of the cardiovascular system, in particular of the myocardium, to the effect of constant and, especially, alternating magnetic fields was demonstrated by many authors. However, the biochemical mechanisms forming the basis for the development of functional and structural disturbances in the myocardium have not been clarified in many respects. N.A. Udintsev and N.V. Kanskaya have established that the effect of alternating magnetic fields leads to the activation in the heart muscle of glycolysis and glycogenolysis and to the inhibition of the pentose cycle. In the literature there are no data on the state of oxidation processes and phosphorylation associated with them, in the course of which energy needed both for synthesis and contraction processes' in the myocardium is accumulated. The study of the features of metabolism of carbohydrates, macroergic phosphates and low-molecular nitrogen compounds in the rat heart under the effect of alternating magnetic fields of various voltages and exposures was the object of this investigation.

  5. Dynamic 13C NMR analysis of oxidative metabolism in the in vivo canine myocardium.

    Science.gov (United States)

    Robitaille, P M; Rath, D P; Abduljalil, A M; O'Donnell, J M; Jiang, Z; Zhang, H; Hamlin, R L

    1993-12-15

    Oxidative metabolism in the in vivo canine myocardium was studied noninvasively using 13C-enriched acetate and non-steady state 13C NMR techniques. Under low workload conditions, the myocardium oxidized the infused [2-13C]acetate and incorporated the labeled carbon into the glutamate pool as expected. This conclusion stems from the rapid enrichment of the C-2, C-3, and C-4 carbons of glutamic acid both under in vivo conditions and in extracts. Surprisingly, [2-13C]acetate uptake was not observed at high workloads as reflected by an absence of glutamate pool enrichment at these rate pressure products. Rather, the myocardium selected its substrate from an endogenous pool. Since free acetate can directly cross the inner mitochondrial membrane and be converted to acetyl-CoA through acetyl-CoA synthetase, these results support workload-dependent regulation of substrate access to the mitochondrial CoASH pool. As such, we advance the hypothesis that the selection of substrate for condensation with CoASH and subsequent oxidation in the tricarboxylic acid cycle is regulated kinetically through the Km values of the appropriate condensation enzymes and through the absolute levels of free CoASH in the mitochondria. PMID:8253751

  6. Protective effects of erythropoietin pretreatment on myocardium with hypoxia/reoxygenation injury in rats

    Institute of Scientific and Technical Information of China (English)

    QIN Chuan; XIAO Ying-bin; ZHONG Qan-jin; CHEN Lin; WANG Xue-feng

    2004-01-01

    To establish the rat model with myocardial hypoxia/reoxygenation (H/R) injury, and investigatethe protective effect of EPO pretreatment on the myocardium. Methods: Sixty male adult Wistar rats were randomly divided in-to 3 groups: control group, H/R group, and EPO group, 20 in each group. The rats in EPO group accepted injection of 5 000U/kg recombinant human erythropoietin (RHuEPO) through vein, and the other rats accepted the injection of the same volumeof saline. Twenty-four hours after the injection, rats in the EPO and H/R groups were put into the hypoxia environment for 12h and then returned to the normoxic environment for 2 h, and then the samples of blood and myocardium were collected. Serummyocardial enzyme activity, apoptosis, ultrastructure, myocardial MDA contents, EPO receptor (EPOR) expression in cardiacmyocytes and cardiac functions were tested. Results: EPOR expression was positive in cardiac myocytes of adult rat according to the result of immunohistochemitry assaying. Compared to those in H/R group, rats in EPO group presented lighter injury ofmyocardial ultrastructure, the reduction of serum myocardial enzyme activity, inhibition of apoptosis, the better recovery ofcardiac functions, and the Ness production of oxygen-derived free radicals. Conclusion: Adult rat cardiac myocytes could ex-press EPOR, and EPO pretreatment produced protective effects on myocardium with H/R injury.

  7. Ca2+ signalling in the myocardium by (redox regulation of PKA/CaMKII

    Directory of Open Access Journals (Sweden)

    Alex S Johnston

    2015-08-01

    Full Text Available Homeostatic cardiac function is maintained by a complex network of interdependent signaling pathways which become compromised during disease progression. Excitation-contraction-coupling, the translation of an electrical signal to a contractile response is critically dependent on a tightly controlled sequence of events culminating in a rise in intracellular Ca2+ and subsequent contraction of the myocardium. Dysregulation of this Ca2+ handling system as well as increases in the production of reactive oxygen species (ROS are two major contributing factors to myocardial disease progression. ROS, generated by cellular oxidases and by-products of cellular metabolism, are highly reactive oxygen derivatives that function as key secondary messengers within the heart and contribute to normal homeostatic function. However, excessive production of ROS, as in disease, can directly interact with kinases critical for Ca2+ regulation. This post-translational oxidative modification therefore links changes in the redox status of the myocardium to phospho-regulated pathways essential for its function. This review aims to describe the oxidative regulation of the Ca2+/calmodulin-dependent kinase II (CaMKII and cAMP-dependent protein kinase A (PKA, and the subsequent impact this has on Ca2+ handling within the myocardium. Elucidating the impact of alterations in intracellular ROS production on Ca2+ dynamics through oxidative modification of key ROS sensing kinases, may provide novel therapeutic targets for preventing myocardial disease progression.

  8. Myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Yu-Jun Zhao

    2016-01-01

    Objective:To study the myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction and explore the possible molecular mechanisms. Methods:A total of 84 patients with acute myocardial infarction who received emergency PCI treatment in our hospital from February 2014 to October 2015 were selected for study and randomly divided into and ticagrelor group and clopidogrel group that received different perioperative anti-platelet therapy. Degree of myocardial cell damage, cardiac pump function as well as blood perfusion and platelet aggregation function of two groups were evaluated. Results:Before as well as 10 min and 24 h after PCI, plasma CK-MB and cTnI levels as well as maximum platelet aggregation rate and P2Y12 reaction unit of ticagrelor group were significantly lower than those of clopidogrel group, and ADP-way platelet inhibition rate were higher than those of clopidogrel group; after PCI, TIMI blood flow grade, TMP myocardial perfusion grade and LVEF of ticagrelor group were significantly higher than those of clopidogrel group, LVEDD was significantly lower than that of clopidogrel group and the number of cases with no reflow/slow flow was less than that of clopidogrel group. Conclusions:The myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction is better than that of clopidogrel, and ticagrelor can enhance the anti-platelet aggregation effect to exert myocardium-protective effect.

  9. Changes in expression of adrenomedullin in the myocardium of streptozotocin-induced diabetic rats

    Institute of Scientific and Technical Information of China (English)

    HE Rong-xin; GU Chuan-long; SHEN Fang; ZHANG Xiao-ming

    2007-01-01

    Background Adrenomedullin is a potent vasodilating peptide and involved in many cardiovascular diseases. However,whether adrenomedullin is involved in the pathogenesis of diabetic cardiomyopathy is still unknown. Our aim was to characterize the expression pattern of adrenomedullin in the myocardium of streptozotocin-induced diabetic rats.Methods The weight, blood glucose, and urine glucose of 20 streptozotocin-induced diabetic rats were measured before and after model induction in the diabetic and control groups. The alteration of the adrenomedullin expression was explored in the left ventricular myocardium in both groups by immunohistochemistry. Changes in heart ultrastructure were also analyzed by using hemotoxylin and eosin staining and transmission electron microscopy. All data were analyzed by the independent samples ttest.Results The data of weight, blood glucose, and urine glucose had no significant difference between the control and the diabetic groups before animal model induction. Four weeks after the induction of diabetes, the differences between the two groups in weight, blood glucose, and urine glucose were distinct. When compared with the control group, the diabetic group showed ultrastructural changes including hypertrophy, fibrosis, myofibrillar disarrangements, mitochonddal disruption, and increase in nuclear membrane invaginations. A significant decrease of adrenomedullin expression was also observed in cardiac myocytes of the diabetic rats (P<0.01).Conclusions Our study provides experimental evidence that hyperglycemia could damage cardiac myocytes.Down-regulation of cardioprotective peptide adrenomedullin in the myocardium of streptozotocin-induced diabetic rats may contribute to the diabetic cardiomyopathy and left ventricular dysfunction.

  10. The Relation Between Hypertrophied Myocardium and Ventricular Fibrillation Threshold in Spontaneously Hypertensive Rats

    Institute of Scientific and Technical Information of China (English)

    Huang Zhibin; Wu Wei; Deng Yijun; Fang Chang; Wei Yulin; Zhou Shuxian; Wang Jingfeng

    2006-01-01

    Objectives To investigate the relation between hypertrophied myocardium and ventricular fibrillation threshold in spontaneously hypertensive rats (SHR). Methods 20 male SHR were randomly divided into two groups: 10 week group (n=10) and 18 week group (n=10). 10week male Wistar rats were controlled group (n=10). The systolic blood pressure (SBP), heart mass index (HMI), ventricular effective refractory period (VERP) and ventricular fibrillation threshold(VFT) were measured respectively.Results ① The SBP and HMI of SHR were significantly higher than those of Wistar rats(P<0.001).The VFT of SHR were significantly lower than that of Wistar rats (P < 0.001). ②In SHR, the SBP and HMI of 18 week SHR were significantly higher than those of 10 week SHR (P < 0.001). The VFT of 18 week SHR were significantly lower than that of 10 week SHR (P<0.001). ③There were no significant difference of VERP among 10 week SHR, 18 week SHR and Wistar rats(P > 0.05). ④There was no relationship between HMI and VFT or SBP in Wistar rats. There was significant relationship between HMI and VFT or SBP in different age spontaneously hypertensive rats. ⑤HMI, age and species of animal were the major influent factors of VFT. Conclusions The VFT of hypertrophied myocardium decreased. The higher the degree of hypertrophy of myocardium and the higher the systolic blood pressure were, the lower the ventricular fibrillation threshold was.

  11. Blood pressure, risk of ischemic cerebrovascular and ischemic heart disease, and longevity in alpha(1)-antitrypsin deficiency

    DEFF Research Database (Denmark)

    Dahl, Morten; Tybjaerg-Hansen, Anne; Sillesen, Henrik;

    2003-01-01

    Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity.......Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity....

  12. Combined transfer of human VEGF165 and HGF genes renders potent angiogenic effect in ischemic skeletal muscle.

    Directory of Open Access Journals (Sweden)

    Pavel Makarevich

    Full Text Available Increased interest in development of combined gene therapy emerges from results of recent clinical trials that indicate good safety yet unexpected low efficacy of "single-gene" administration. Multiple studies showed that vascular endothelial growth factor 165 aminoacid form (VEGF165 and hepatocyte growth factor (HGF can be used for induction of angiogenesis in ischemic myocardium and skeletal muscle. Gene transfer system composed of a novel cytomegalovirus-based (CMV plasmid vector and codon-optimized human VEGF165 and HGF genes combined with intramuscular low-voltage electroporation was developed and tested in vitro and in vivo. Studies in HEK293T cell culture, murine skeletal muscle explants and ELISA of tissue homogenates showed efficacy of constructed plasmids. Functional activity of angiogenic proteins secreted by HEK293T after transfection by induction of tube formation in human umbilical vein endothelial cell (HUVEC culture. HUVEC cells were used for in vitro experiments to assay the putative signaling pathways to be responsible for combined administration effect one of which could be the ERK1/2 pathway. In vivo tests of VEGF165 and HGF genes co-transfer were conceived in mouse model of hind limb ischemia. Intramuscular administration of plasmid encoding either VEGF165 or HGF gene resulted in increased perfusion compared to empty vector administration. Mice injected with a mixture of two plasmids (VEGF165+HGF showed significant increase in perfusion compared to single plasmid injection. These findings were supported by increased CD31+ capillary and SMA+ vessel density in animals that received combined VEGF165 and HGF gene therapy compared to single gene therapy. Results of the study suggest that co-transfer of VEGF and HGF genes renders a robust angiogenic effect in ischemic skeletal muscle and may present interest as a potential therapeutic combination for treatment of ischemic disorders.

  13. Protective effects of calmodulin antagonists (trifluoperazine and W-7 on hypothermic ischemic rat hearts.

    Directory of Open Access Journals (Sweden)

    Sugawara,Eiji

    1991-06-01

    Full Text Available The cardioprotective effect of calmodulin antagonists, trifluoperazine (TFP and N-(6-aminohexyl-5-chloro-1-naphthalene sulfonamide (W-7 was examined on the isolated rat heart exposed to hypothermic and ischemic conditions by measuring distribution of lysosomal enzymes in myocardial cells, and leakage of creatine kinase (CK during reperfusion and postischemic recovery in myocardial systolic function. Experimental hearts were infused with 20 degrees C Krebs-Henseleit bicarbonate buffer (KHB or KHB containing TFP or W-7 for 2min every 30min during hypothermic ischemia. After ischemia for 120min at 20 degrees C, rat hearts were reperfused at 37 degrees C for 30min. TFP and W-7 improved functional recovery and prevented CK release. In TFP treated hearts, leakage of lysosomal enzymes was reduced significantly, whereas stabilization of lysosomes by W-7 did not occur. These results suggest that calcium-calmodulin dependent enzymes may play an important role in the development of cellular damage of the myocardium during hypothermic ischemia, although levels of leakage of lysosomal enzymes may be unreliable predictors of functional recovery after hypothermic ischemia.

  14. Exosomes Derived from Human Umbilical Cord Mesenchymal Stem Cells Relieve Acute Myocardial Ischemic Injury

    Directory of Open Access Journals (Sweden)

    Yuanyuan Zhao

    2015-01-01

    Full Text Available This study is aimed at investigating whether human umbilical cord mesenchymal stem cell- (hucMSC- derived exosomes (hucMSC-exosomes have a protective effect on acute myocardial infarction (AMI. Exosomes were characterized under transmission electron microscopy and the particles of exosomes were further examined through nanoparticle tracking analysis. Exosomes (400 μg protein were intravenously administrated immediately following ligation of the left anterior descending (LAD coronary artery in rats. Cardiac function was evaluated by echocardiography and apoptotic cells were counted using TUNEL staining. The cardiac fibrosis was assessed using Masson’s trichrome staining. The Ki67 positive cells in ischemic myocardium were determined using immunohistochemistry. The effect of hucMSC-exosomes on blood vessel formation was evaluated through tube formation and migration of human umbilical vein endothelial cells (EA.hy926 cells. The results indicated that ligation of the LAD coronary artery reduced cardiac function and induced cardiomyocyte apoptosis. Administration of hucMSC-exosomes significantly improved cardiac systolic function and reduced cardiac fibrosis. Moreover, hucMSC-exosomes protected myocardial cells from apoptosis and promoted the tube formation and migration of EA.hy926 cells. It is concluded that hucMSC-exosomes improved cardiac systolic function by protecting myocardial cells from apoptosis and promoting angiogenesis. These effects of hucMSC-exosomes might be associated with regulating the expression of Bcl-2 family.

  15. Mesenchymal stem cell delivery strategies to promote cardiac regeneration following ischemic injury.

    Science.gov (United States)

    Russo, Valerio; Young, Stuart; Hamilton, Andrew; Amsden, Brian G; Flynn, Lauren E

    2014-04-01

    Myocardial infarction (MI) is one of the leading causes of mortality worldwide and is associated with irreversible cardiomyocyte death and pathological remodeling of cardiac tissue. In the past 15 years, several animal models have been developed for pre-clinical testing to assess the potential of stem cells for functional tissue regeneration and the attenuation of left ventricular remodeling. The promising results obtained in terms of improved cardiac function, neo-angiogenesis and reduction in infarct size have motivated the initiation of clinical trials in humans. Despite the potential, the results of these studies have highlighted that the effective delivery and retention of viable cells within the heart remain significant challenges that have limited the therapeutic efficacy of cell-based therapies for treating the ischemic myocardium. In this review, we discuss key elements for designing clinically translatable cell-delivery approaches to promote myocardial regeneration. Key topics addressed include cell selection, with a focus on mesenchymal stem cells derived from the bone marrow (bMSCs) and adipose tissue (ASCs), including a discussion of their potential mechanisms of action. Natural and synthetic biomaterials that have been investigated as injectable cell delivery vehicles for cardiac applications are critically reviewed, including an analysis of the role of the biomaterials themselves in the therapeutic scheme. PMID:24560461

  16. Ischemic enterocolitis examined by colonoscopy and selective angiography

    Institute of Scientific and Technical Information of China (English)

    Lei He; He-Sheng Luo

    2005-01-01

    AIM: To study the value of colonoscopy and selective angiography in diagnosing ischemic enterocolitis.METHODS: Among the 16 cases under study, 10 cases had hypertension and a history of coronary artery disease (one was hospitalized for sub-ventricular-wall infarction). The blood pressure of 10 of the 16 cases ranged from 13.9-23.8 to 13.3-14.6 kPa (170-180/100-110 mmHg). Two cases had chronic auricular fibrillation, and in four cases, a cardiogram showed left-front branch conduction block. Sixteen patients were examined by colonoscopy. Among them, 14 cases had a long course of angiocardiac disease, and were further examined by selective mesenteric inferior angiography.RESULTS: The colonoscopy revealed local mucous hyperemia edema and blood on contact. Lesions were found in the sigmoid colon in four cases, in the descending colon in eight cases and in splenic flexure in four cases, which suggests that the lesion always appeared in the left part of colon. There were different degrees of inflammatory cell infiltration, submucous bleeding, edema, fibro-embolism and hemosiderosis by biopsy in the 16 patients whose membranes affect part of the enteral wall. Of the 14 patients examined by mesenteric inferior angiography, 3 cases showed mesenteric amphraxis inferior and formation of collateral circulation. There were different degrees of stenosis in the other 11 subjects' mesenteric inferior cavities which grew slim and their branches were stenotic, so the radiographic image was not complete and the ends of some branches even cannot be seen. CONCLUSION: The colonoscopy and the selective mesenteric inferior angiography are both helpful in the diagnosis of ischemic enterocolitis.

  17. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes

    Directory of Open Access Journals (Sweden)

    Robert Perna

    2015-01-01

    Full Text Available Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic (n=172 or hemorrhagic stroke (n=112 within the past six months and were involved in a postacute neurorehabilitation program. Participants completed three months of postacute neurorehabilitation and the Mayo Portland Adaptability Inventory-4 (MPAI-4 at admission and discharge. Admission MPAI-4 scores and level of functioning were comparable. Results. Group ANOVA comparisons show no significant group differences at admission or discharge or difference in change scores. Both groups showed considerably reduced levels of productivity/employment after discharge as compared to preinjury levels. Conclusions. Though the pathophysiology of these types of strokes is different, both ultimately result in ischemic injuries, possibly accounting for lack of findings of differences between groups. In the present study, participants in both groups experienced similar functional levels across all three MPAI-4 domains both at admission and discharge. Limitations of this study include a highly educated sample and few outcome measures.

  18. Surgical strategy for mild ischemic mitral insufficiency

    Institute of Scientific and Technical Information of China (English)

    GU Cheng-xiong; WEI Hua; YU Yang

    2010-01-01

    @@ To the Editor: We read with the interest the article by FAN Hong-guang and colleagues~1 having obtained outstanding early and long-term clinical outcomes of left ventricular restoration for the patients with postinfarction ventricular aneurysm and low left ventricular ejection fraction (LVEF) of mean 37.7%. We would like to comment on surgical strategy for mild ischemic mitral insufficiency.

  19. Ischemic Stroke during Pregnancy and Puerperium

    Directory of Open Access Journals (Sweden)

    Elisabetta Del Zotto

    2011-01-01

    Full Text Available Ischemic stroke during pregnancy and puerperium represents a rare occurrence but it could be a serious and stressful event for mothers, infants, and also families. Whenever it does occur, many concerns arise about the safety of the mother and the fetus in relation to common diagnostic tests and therapies leading to a more conservative approach. The physiological adaptations in the cardiovascular system and in the coagulability that accompany the pregnant state, which are more significant around delivery and in the postpartum period, likely contribute to increasing the risk of an ischemic stroke. Most of the causes of an ischemic stroke in the young may also occur in pregnant patients. Despite this, there are specific conditions related to pregnancy which may be considered when assessing this particular group of patients such as pre-eclampsia-eclampsia, choriocarcinoma, peripartum cardiomiopathy, amniotic fluid embolization, and postpartum cerebral angiopathy. This article will consider several questions related to pregnancy-associated ischemic stroke, dwelling on epidemiological and specific etiological aspects, diagnostic issue concerning the use of neuroimaging, and the related potential risks to the embryo and fetus. Therapeutic issues surrounding the use of anticoagulant and antiplatelets agents will be discussed along with the few available reports regarding the use of thrombolytic therapy during pregnancy.

  20. The neuroprotective mechanism of brain ischemic preconditioning

    Institute of Scientific and Technical Information of China (English)

    Xiao-qian LIU; Rui SHENG; Zheng-hong QIN

    2009-01-01

    Brain ischemia is one of the most common causes of death and the leading cause of adult disability in the world. Brain ischemic pre- conditioning (BIP) refers to a transient, sublethal ischemia which results in tolerance to later, otherwise lethal, cerebral ischemia. Many attempts have been made to understand the molecular and cellular mechanisms underlying the neuroprotection offered by ischemic preconditioning. Many studies have shown that neuroprotective mechanisms may involve a series of molecular regulatory pathways including activation of the N-methyI-D-aspartate (NMDA) and adenosine receptors; activation of intracellular signaling pathways such as mitogen activated protein kinases (MAPK) and other protein kinases; upregulation of Bcl-2 and heat shock proteins (HSPs); and activation of the ubiquitin-proteasome pathway and the autophagic-lysosomal pathway. A better understanding of the processes that lead to cell death after stroke as well as of the endogenous neuroprotective mechanisms by which BIP protects against brain ischemic insults could help to develop new therapeutic strategies for this devastating neurological disease. The purpose of the present review is to summarize the neuroprotective mechanisms of BIP and to discuss the possibility of mimicking ischemic preconditioning as a new strategy for preventive treatment of ischemia.

  1. Remnant cholesterol and ischemic heart disease

    DEFF Research Database (Denmark)

    Varbo, Anette; Nordestgaard, Børge G

    2014-01-01

    PURPOSE OF REVIEW: To review recent advances in the field of remnant cholesterol as a contributor to the development of ischemic heart disease (IHD). RECENT FINDINGS: Epidemiologic, mechanistic, and genetic studies all support a role for elevated remnant cholesterol (=cholesterol in triglyceride...

  2. Cerebral Ischemic Preconditioning: the Road So Far….

    Science.gov (United States)

    Thushara Vijayakumar, N; Sangwan, Amit; Sharma, Bhargy; Majid, Arshad; Rajanikant, G K

    2016-05-01

    Cerebral preconditioning constitutes the brain's adaptation to lethal ischemia when first exposed to mild doses of a subtoxic stressor. The phenomenon of preconditioning has been largely studied in the heart, and data from in vivo and in vitro models from past 2-3 decades have provided sufficient evidence that similar machinery exists in the brain as well. Since preconditioning results in a transient protective phenotype labeled as ischemic tolerance, it can open many doors in the medical warfare against stroke, a debilitating cerebrovascular disorder that kills or cripples thousands of people worldwide every year. Preconditioning can be induced by a variety of stimuli from hypoxia to pharmacological anesthetics, and each, in turn, induces tolerance by activating a multitude of proteins, enzymes, receptors, transcription factors, and other biomolecules eventually leading to genomic reprogramming. The intracellular signaling pathways and molecular cascades behind preconditioning are extensively being investigated, and several first-rate papers have come out in the last few years centered on the topic of cerebral ischemic tolerance. However, translating the experimental knowledge into the clinical scaffold still evades practicality and faces several challenges. Of the various preconditioning strategies, remote ischemic preconditioning and pharmacological preconditioning appears to be more clinically relevant for the management of ischemic stroke. In this review, we discuss current developments in the field of cerebral preconditioning and then examine the potential of various preconditioning agents to confer neuroprotection in the brain. PMID:26081149

  3. The diagnosis of transient ischemic attacks

    NARCIS (Netherlands)

    P.J. Koudstaal (Peter Jan)

    1989-01-01

    textabstractThe diagnosis of transient ischemic attack (TIA) is fraught with difficulty, since the diagnosis rests entirely upon the history of the patient's symptoms and the neurologist's skill in questioning the patient. The aim of this thesis is to investigate various measures to improve the reli

  4. Analysis of the relationship cost-effectiveness of the myocardial gammagraphy studies and the impact to the total expenditure by diagnostic of ischemic cardiopathy

    International Nuclear Information System (INIS)

    Recent advances in pharmacology, diagnostic and invasive procedures provide a series of modalities that diminish the morbidity and increase the long term survival in the patients that have suffered a heart attack to myocardium. The stratification by risk is an essential element for the handling of the survivors of heart attack to myocardium. In their attention it is looked for to optimize the therapeutic benefit, to diminish the unnecessary diagnostic and therapeutic procedures and to improve the efficiency. For example, a coronariography in sick with heart attack to myocardium it is not cost-effective if not is clinically suitable. Of there that from the institutional point of view, this is, of the Mexican Institute of the Public Health, they are required of appropriate reference approaches and counter reference to grant to the sick person, the best service that is the one in this case the diagnostic and the handling of the ischemic cardiopathy with the smallest waste of resources. The estimation of the annual survival is the base of the stratification, it constitutes the angular stone of the early handling of the heart attack to myocardium. The goal for the clinical would be to identify patients with intermediate risk, since, this risk makes them candidates to therapy interventionist. As long as those with low risk won't require intervention. This would allow the decrease of rates by revenues of heart attack to myocardium, and therefore to diminish the hospital staying rates. The Nuclear Cardiology (myocardial gammagraphy) it is not the only invasive method available to evaluate the myocardial perfusion in sick in who coronary illness is suspected. When the myocardial gammagraphy is carried out in appropriate population, the cost it diminishes because it restricts the necessity of additional invasive evaluations. This because the nuclear cardiology has predictive value so much for the mortality like to detect myocardial viability. Based on these probabilities

  5. Digital ischemic necrosis caused by pegylated interferon in a patient with hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Jana; G; Hashash; Sean; A; Tackett; David; J; McAdams

    2011-01-01

    Pegylated interferon plus ribavirin remains the firstline treatment for patients with hepatitis C virus(HCV) . Interferonαhas the most extensive clinical application and is used for the treatment of chronic hepatitis B virus and hepatitis D virus as well as acute and chronic HCV infections.The attachment of polyethylene glycol to interferon increases its half-life by reducing the rate of absorption after injection,reducing renal and cellular clearance and also decreasing immunogenicity.In this case report,we have described a patient with chronic hepatitis C who developed ischemic necrosis of her fingertips after completing her third course of pegylated interferon and ribavirin.The patient underwent a very extensive workup in order to determine the underlying cause of her digital ischemia which was finally determined to be secondary to the use of pegylated interferon.

  6. EFFECTS OF GLIBENCLAMIDE, GLIMEPIRIDE, AND GLICLAZIDE ON ISCHEMIC PRECONDITIONING IN RAT HEART

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To compare the influence of different sulfonylureas on the myocardial protection effect of ischemic preconditioning (IPC) in isolated rat hearts, and ATP-sensitive potassium channel current (IKATP ) of rat ventricular myocytes.Methods Isolated Langendorff perfused rat hearts were randomly assigned to five groups: ( 1 ) control group, (2)IPC group, (3) IPC + glibenclamide (GLB, 10 μmol/L) group, (4) IPC + glimepiride (GLM, 10 μmol/L) group,(5) IPC + gliclazide ( GLC, 50 μmol/L ) group. IPC was defined as 3 cycles of 5 -minute zero-flow global ischemia followed by 5-minute reperfusion. The haemodynamic parameters and the infarct size of each isolated heart were recorded.And the sarcolemmal IKATP of dissociated ventricular myocytes reperfused with 10 μmol/L GLB, 1 μmol/L GLM, and 1μmol/L GLC was recorded with single-pipette whole-cell voltage clamp under simulated ischemic condition.Results The infarct sizes of rat hearts in IPC (23.7% ± 1.3% ), IPC + GLM (24. 6% ± 1.0% ), and IPC +GLC (33. 1% ±1.3% ) groups were all significantly smaller than that in control group (43.3% ±1.8%; P <0. 01, n=6). The infarct size of rat hearts in IPC + GLB group (40.4% ± 1.4% ) was significantly larger than that in IPC group (P <0. 01, n =6). Under simulated ischemic condition, GLB ( 10 μmol/L) decreased IKATP from 20. 65 ± 7.80 to 9. 09 ± 0. 10 pA/pF (P < 0. 01, n = 6), GLM ( 1 μ mol/L) did not significantly inhibit IKATP ( n = 6 ), and GLC ( 1μmol/L) decreased IKATP from 16.73 ± 0. 97 to 11.18 ± 3.56 pA/pF ( P < 0. 05, n = 6).Conclusions GLM has less effect on myocardial protection of IPC than GLB and GLC. Blockage of sarcolemmal ATP-sensitive potassium channels in myocardium might play an important role in diminishing IPC-induced protection of GLM, GLB, and GLC.

  7. Chronic conditions in adults with cerebral palsy

    OpenAIRE

    Peterson, MD; Ryan, JM; Hurvitz, EA; E Mahmoudi

    2015-01-01

    Adults with cerebral palsy (CP) represent a growing population whose health status and healthcare needs are poorly understood.1 Mortality records reveal that death due to ischemic heart disease and cancer is higher among adults with CP;2 however, there have been no national surveillance efforts to track disease risk in this population. We examined estimates of chronic conditions in a population-representative sample of adults with CP.

  8. Role of Mitochondrial Enzymes and Sarcoplasmic ATPase in Cardioprotection Mediated by Aqueous Extract of Desmodium gangeticum (L) DC Root on Ischemic Reperfusion Injury.

    Science.gov (United States)

    Kurian, G A; Paddikkala, J

    2010-11-01

    The present study investigate the protective effect of aqueous root extract of Desmodium gangeticum in preserving mitochondrial and sarcoplasmic ATPase during ischemia reperfusion injury. The isolated rat hearts in both drug and control group were subjected to warm ischemia (37°), followed by reperfusion with the Langendorff perfusion system. The aqueous root extract of Desmodium gangeticum (L) at a dose of 50 mg/kg body weight was found to be effective in the rat heart for the management of ischemic reperfusion injury. Physiological parameters were significantly (PDesmodium gangeticum treated rat heart. These results suggest that Desmodium gangeticum aqueous root extract can preserve the mitochondrial and sarcoplasmic ATPase in the myocardium, resulting in the improvement of cardiac function after ischemia reperfusion injury. PMID:21969747

  9. Dynamic MRI of ferumoxide-labeled bone mesenchmal stem cells after transplantation in infarcted myocardium

    International Nuclear Information System (INIS)

    Objective: To investigate the ability of magnetic resonance imaging (MRI) in tracking magnetically labeled mesenchymal stem cells (MR-MSCs) in a swine myocardial infarction (MI) model. Methods: Adult Chinese mini-pigs (n=6) were subjected to open-chest experimental MI operation. Their autogeneic bone marrow-derived mesenchymal stem cells (MSCs) was cultured and doubly labeled with ferumoxides and DAPI. On the 14 th day after MSCs transplantation, the size and location of the myocardial infarction were assessed by using delayed-enhancement MRI (DE-MRI). Then the labeled MSCs were injected intramyocardially into peri-infarct zone and normal myocardium. At 24 hrs and 3 weeks after injection, the contrast and the volume of the MR-MSCs hypointense lesion from the MR images were acquired, and the contrast was determined using the difference in signal intensity between the hypointense and normal myocardium divided by signal intensity of the normal region. After humane euthanasia, the heart was excised and histology corresponding to MRI slices that demonstrated MR-MSCs lesions was performed. Repeated-measures ANOVA and a paired t test were used for comparison of the contrast and the volume of the MR-MSCs hypointense lesion at different time points. Comparisons between independent groups were performed with the standard Student t test. Results: The labeling efficiency of ferumoxides and DAPI was 100%. On the 14 th day after the MI operation, the average percentage of infracted myocardial area was (33.6±8.9)%. Twenty- four hours after MSCs transplantation, MSCs injection sites appeared as ovoid hypointensive lesions with sharp border on T2* images. At 24 h after injection, the signal contrast [(67.00±5.48)% vs (61.92±7.76)%,t=1.65, P=0.1158] and the size [(0.56±0.24) cm2 vs (0.52±0.25) cm2, t=0.39, P=0.7044] of the lesions showed no statistical difference between the peri-infarct zone and the normal myocardium. At 3 weeks after injection, the signal contrast decreased

  10. Effects of autologous bone marrow stem cell transplantation on beta-adrenoceptor density and electrical activation pattern in a rabbit model of non-ischemic heart failure

    Directory of Open Access Journals (Sweden)

    Ullmann Cris

    2006-06-01

    Full Text Available Abstract Background Since only little is known on stem cell therapy in non-ischemic heart failure we wanted to know whether a long-term improvement of cardiac function in non-ischemic heart failure can be achieved by stem cell transplantation. Methods White male New Zealand rabbits were treated with doxorubicine (3 mg/kg/week; 6 weeks to induce dilative non-ischemic cardiomyopathy. Thereafter, we obtained autologous bone marrow stem cells (BMSC and injected 1.5–2.0 Mio cells in 1 ml medium by infiltrating the myocardium via a left anterolateral thoracotomy in comparison to sham-operated rabbits. 4 weeks later intracardiac contractility was determined in-vivo using a Millar catheter. Thereafter, the heart was excised and processed for radioligand binding assays to detect β1- and β2-adrenoceptor density. In addition, catecholamine plasma levels were determined via HPLC. In a subgroup we investigated cardiac electrophysiology by use of 256 channel mapping. Results In doxorubicine-treated animals β-adrenoceptor density was significantly down-regulated in left ventricle and septum, but not in right ventricle, thereby indicating a typical left ventricular heart failure. Sham-operated rabbits exhibited the same down-regulation. In contrast, BMSC transplantation led to significantly less β-adrenoceptor down-regulation in septum and left ventricle. Cardiac contractility was significantly decreased in heart failure and sham-operated rabbits, but was significantly higher in BMSC-transplanted hearts. Norepinephrine and epinephrine plasma levels were enhanced in heart failure and sham-operated animals, while these were not different from normal in BMSC-transplanted animals. Electrophysiological mapping revealed unaltered electrophysiology and did not show signs of arrhythmogeneity. Conclusion BMSC transplantation improves sympathoadrenal dysregualtion in non-ischemic heart failure.

  11. Differential activation of protein kinase A in various regions of myocardium during sepsis.

    Science.gov (United States)

    Hsu, C; Yang, S L; Hsu, S P; Hsu, H K; Liu, M S

    1997-08-01

    Changes in the activities of protein kinase A (PKA) (cAMP-dependent protein kinase) in various regions of rat myocardium during different cardiodynamic phases of sepsis were studied in an attempt to understand the pathophysiology of cardiac dysfunction during sepsis. Sepsis was induced by cecal ligation and puncture (CLP). Experiments were divided into three groups: control, early sepsis, and late sepsis. Early and late sepsis refers to those animals sacrificed at 9 and 18 hr, respectively, after CLP. Cardiac PKA was extracted and partially purified by acid precipitation, ammonium sulfate fractionation, and DEAE-cellulose chromatography. PKA was eluted from DEAE-cellulose column with a linear NaCl gradient. Two types of PKA, Type I (eluted at low ionic strength) and Type II (eluted at high ionic strength), were collected, and their activities were determined based on the rate of incorporation of [gamma-32P]ATP into histone. Under physiological conditions, Type I PKA activities were unevenly distributed (left atrium > right atrium > pacemaker region > left ventricle > right ventricle > ventricular septum) while Type II PKA activities were evenly distributed among different regions of myocardium. During early sepsis, Type I PKA activities remained unchanged while Type II PKA activities were activated by 32 and 70% in right atrium and pacemaker regions, respectively. During late sepsis, Type I PKA activities were stimulated by 228% in ventricular septum while Type II PKA activities were not affected. These data demonstrate that different PKA activities exist in various regions of the myocardium and that PKA activities were preferentially activated in certain areas during the progression of sepsis. Since PKA plays an important role in the regulation of myocardial function and metabolism, the activation of PKA in different regions of myocardial during different stages of sepsis may contribute to the altered cardiac function during the progression of sepsis. PMID:9299285

  12. In vivo mechanical study of helical cardiac pacing electrode interacting with canine myocardium

    Institute of Scientific and Technical Information of China (English)

    Xiangming Zhang; Nianke Ma; Hualin Fan; Guodong Niu; Wei Yang

    2007-01-01

    Cardiac pacing is a medical device to help human to overcome arrhythmia and to recover the regular beats of heart. A helical configuration of electrode tip is a new type of cardiac pacing lead distal tip. The helical electrode attaches itself to the desired site of heart by screwing its helical tip into the myocardium. In vivo experiments on anesthetized dogs were carried out to measure the acute interactions between helical electrode and myocardium during screw-in and pull-out processes. These data would be helpful for electrode tip design and electrode/myocardium adherence safety evaluation. They also provide reliability data for clinical site choice of human heart to implant and to fix the pacing lead.A special design of the helical tip using strain gauges is instrumented for the measurement of the screw-in and pull-out forces. We obtained the data of screw-in torques and pull-out forces for five different types of helical electrodes at nine designed sites on ten canine hearts. The results indicate that the screw-in torques increased steplike while the torque-time curves presente saw-tooth fashion. The maximum torque has a range of 0.3-1.9N mm. Obvious differences are observed for different types of helical tips and for different test sites.Large pull-out forces are frequently obtained at epicardium of left ventricle and right ventricle lateral wall, and the forces obtained at right ventricle apex and outflow tract of right ventricle are normally small. The differences in pull-out forces are dictated by the geometrical configuration of helix and regional structures of heart muscle.

  13. Losartan reduced connexin43 expression in left ventricular myocardium of spontaneously hypertensive rats

    Institute of Scientific and Technical Information of China (English)

    Li-li ZHAO; Hong-juan CHEN; Jun-zhu CHEN; Min YU; Yun-lan NI; Wei-fang ZHANG

    2008-01-01

    Objective: To assess the effect of angiotensin Ⅱ type 1 (AT1) receptor antagonist losartan on myocardium connexin43 (Cx43) gap junction (GJ) expression in spontaneously hypertensive rats (SHRs) and investigate possible mechanisms. Methods: Sixteen 9-week-old male SHRs and 8 age-matched male Wistar-Kyoto (WKY) rats were included in this study. SHRs were randomly divided into two groups to receive losartan at 30mg/(kg·d) by oral gavage once daily for 8 weeks (SHR-L) or vehicle (0.9% saline) to act as controls (SHR-V); WKY rats receiving vehicle for 8 weeks served as normotensive controls. At the end of the experiment, rats were sacrificed and the hearts were removed. Expressions of Cx43 and nuclear factor-kappaB p65 (NF-κB p65) proteins in all three groups were observed and further investigations on the effect of angiotensin Ⅱ type 1 receptor antagonist losartan (30mg/(kg·d), 8 weeks) on Cx43 expression were conducted with Western blot and immunohistochemistry. NF-κB p65 protein in nuclear extracts was determined by Western blot. Results: Left ventricular (LV) hypertrophy was prominent in SHRs, Cx43 and NF-κB p65 protein expressions were obviously upregulated and Cx43 distribution was dispersed over the cell surface. Treatment with losarton reduced the over-expressions of Cx43 and NF-κB p65 in LV myocardium. The distribution of Cx43 gap junction also became much regular and confined to intercalated disk after losartan treatment. Conclusion: Cx43 level was upregulated in LV myocardium of SHR during early stage of hypertrophy. Angiotensin Ⅱ type l receptor antagonist losartan prevented Cx43 gap junction remodeling in hypertrophied left ventricles, possibly through the NF-κB pathway.

  14. A rare case of isolated non-compaction right ventricular myocardium

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-juan; ZHI Guang; HOU Hai-jun; ZHOU Xiao

    2009-01-01

    Isolated right ventricular noncompaction (IRNC) is a rare congenital cardiomyopathy resulting from an arrest in normal endomyocardial embryogenesis. The clinical syndrome includes systolic and diastolic dysfunction; some cases may have ventricular arrhythmias. We report a case of a female with the diagnosis of right ventricular non-compaction myocardium (RVNC) with normal left ventricular systolic function. To the best of our knowledge, there have been no reports of isolated ventricular non-compaction involving only the right ventricular before 2008, and there have only been described in very few cases of newborns and adult patients.

  15. Effect of exercise intensity on the expression of UCP2 and energy metabolism in rat myocardium

    OpenAIRE

    Li, Xiao-Yan; Ke MENG; Zhang, Hong-Ming; Ji, Li-li; Zhang, Guo-ming; Jin, Qun; Chen, Ying-Jian

    2015-01-01

    Objective  To study the effect of different exercise intensity on the expression of uncoupling protein 2 (UCP2) in mitochondria of rat myocardium, and investigate the correlation and significance between energy metabolism and UCP2. Methods Forty five male Wistar rats were randomly divided into 3 groups (15 each): normal control (NC) group, endurance exercise (EnE) group and exhaustive exercise (ExE) group. Four weeks later, both the serum concentration of free fatty acid (FFA) and the content...

  16. Viscoelastic properties of pressure overload hypertrophied myocardium: effect of serine protease treatment

    Science.gov (United States)

    Stroud, Jason D.; Baicu, Catalin F.; Barnes, Mary A.; Spinale, Francis G.; Zile, Michael R.

    2002-01-01

    To determine whether and to what extent one component of the extracellular matrix, fibrillar collagen, contributes causally to abnormalities in viscoelasticity, collagen was acutely degraded by activation of endogenous matrix metalloproteinases (MMPs) with the serine protease plasmin. Papillary muscles were isolated from normal cats and cats with right ventricular pressure overload hypertrophy (POH) induced by pulmonary artery banding. Plasmin treatment caused MMP activation, collagen degradation, decreased the elastic stiffness constant, and decreased the viscosity constant in both normal and POH muscles. Thus, whereas many mechanisms may contribute to the abnormalities in myocardial viscoelasticity in the POH myocardium, changes in fibrillar collagen appear to play a predominant role.

  17. Pharmacological role of atorvastatin in myocardium and smooth muscle progenitor cells

    Directory of Open Access Journals (Sweden)

    Suresh Kanna

    2016-06-01

    Full Text Available Atorvastatin is a synthetic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA reductase inhibitor with a great potency in the reduction of lipids and it has been well documented in both primary and secondary prevention studies. It exhibits pleiotropic properties in both in-vitro and in vivo conditions. Conversely, atorvastatin remain under-utilized in several situations. The main objective of this review is to focuses the pharmacological benefits, pleiotropic properties of the atorvastatin related to smooth muscle proliferation and myocardium. [Int J Basic Clin Pharmacol 2016; 5(3.000: 605-608

  18. Inflammation Enhances the Risks of Stroke and Death in Chronic Chagas Disease Patients

    OpenAIRE

    Guedes, Paulo Marcos Matta; de Andrade, Cléber Mesquita; Nunes, Daniela Ferreira; de Sena Pereira, Nathalie; Queiroga, Tamyres Bernadete Dantas; Machado-Coelho, George Luiz Lins; Nascimento, Manuela Sales Lima; Do-Valle-Matta, Maria Adelaide; da Câmara, Antônia Cláudia Jácome; Chiari, Egler; Galvão, Lúcia Maria da Cunha

    2016-01-01

    Ischemic strokes have been implicated as a cause of death in Chagas disease patients. Inflammation has been recognized as a key component in all ischemic processes, including the intravascular events triggered by vessel interruption, brain damage and repair. In this study, we evaluated the association between inflammatory markers and the death risk (DR) and stroke risk (SR) of patients with different clinical forms of chronic Chagas disease. The mRNA expression levels of cytokines, transcript...

  19. Beneficial effect of medicinal plants on the contractility of post-hypoxic isolated guinea pig atria - Potential implications for the treatment of ischemic-reperfusion injury.

    Science.gov (United States)

    Bipat, Robbert; Toelsie, Jerry R; Magali, Indira; Soekhoe, Rubaina; Stender, Karin; Wangsawirana, Angelique; Oedairadjsingh, Krishan; Pawirodihardjo, Jennifer; Mans, Dennis R A

    2016-08-01

    Context Ischemic-reperfusion injury is accompanied by a decreased contractility of the myocardium. Positive-inotropic agents have proven useful for treating this condition but may exert serious side-effects. Objective In this study, aqueous preparations from Abelmoschus esculentus L. Moench (Malvaceae), Annona muricata L. (Annonaceae), Bixa orellana L. (Bixaceae), Cecropia peltata L. (Moraceae), Erythrina fusca Lour. (Fabaceae), Psidium guajava L. (Myrtaceae) and Terminalia catappa L. (Combretaceae) were evaluated for their ability to improve the decreased contractility of isolated guinea pig atria after hypoxic stress. Materials and methods Guinea pig atria isolated in Ringer-Locke buffer gassed with 100% O2 at 30 °C were exposed for 5 min to hypoxia, then allowed to recover in oxygenated buffer alone or containing a single plant extract (0.001-1 mg/mL). The contractility (g/s) and beating frequency (beats/min), as well as troponin C contents of the bathing solution (ng/mL), were determined and expressed as means ± SDs. Results The extracts of A. muricata, B. orellana, C. peltata and T. catappa caused an increase in the contractility compared to untreated atria of 340 ± 102%, 151 ± 13%, 141 ± 14% and 238 ± 44%, respectively. However, the latter two preparations increased the troponin C contents of the bathing solution to 36 ± 11 and 69 ± 33, compared to the value of 11 ± 3 ng/mL found with untreated atria. Conclusions Preparations from A. muricata and B. orellana may possess positive-inotropic properties which may improve the contractility of the post-hypoxic myocardium. Studies to assess their usefulness in ischemic-reperfusion injury are warranted. PMID:26730936

  20. Beneficial effect of medicinal plants on the contractility of post-hypoxic isolated guinea pig atria - Potential implications for the treatment of ischemic-reperfusion injury.

    Science.gov (United States)

    Bipat, Robbert; Toelsie, Jerry R; Magali, Indira; Soekhoe, Rubaina; Stender, Karin; Wangsawirana, Angelique; Oedairadjsingh, Krishan; Pawirodihardjo, Jennifer; Mans, Dennis R A

    2016-08-01

    Context Ischemic-reperfusion injury is accompanied by a decreased contractility of the myocardium. Positive-inotropic agents have proven useful for treating this condition but may exert serious side-effects. Objective In this study, aqueous preparations from Abelmoschus esculentus L. Moench (Malvaceae), Annona muricata L. (Annonaceae), Bixa orellana L. (Bixaceae), Cecropia peltata L. (Moraceae), Erythrina fusca Lour. (Fabaceae), Psidium guajava L. (Myrtaceae) and Terminalia catappa L. (Combretaceae) were evaluated for their ability to improve the decreased contractility of isolated guinea pig atria after hypoxic stress. Materials and methods Guinea pig atria isolated in Ringer-Locke buffer gassed with 100% O2 at 30 °C were exposed for 5 min to hypoxia, then allowed to recover in oxygenated buffer alone or containing a single plant extract (0.001-1 mg/mL). The contractility (g/s) and beating frequency (beats/min), as well as troponin C contents of the bathing solution (ng/mL), were determined and expressed as means ± SDs. Results The extracts of A. muricata, B. orellana, C. peltata and T. catappa caused an increase in the contractility compared to untreated atria of 340 ± 102%, 151 ± 13%, 141 ± 14% and 238 ± 44%, respectively. However, the latter two preparations increased the troponin C contents of the bathing solution to 36 ± 11 and 69 ± 33, compared to the value of 11 ± 3 ng/mL found with untreated atria. Conclusions Preparations from A. muricata and B. orellana may possess positive-inotropic properties which may improve the contractility of the post-hypoxic myocardium. Studies to assess their usefulness in ischemic-reperfusion injury are warranted.

  1. Ischemic colitis due to obstruction of mesenteric and splenic veins: A case report

    Institute of Scientific and Technical Information of China (English)

    Seong-Su Hwang; Woo-Chul Chung; Kang-Moon Lee; Hyun-Jin Kim; Chang-Nyol Paik; Jin-Mo Yang

    2008-01-01

    Ischemic injury to the bowel is a well known disease entity that has a wide spectrum of pathological and clinical findings. A sudden drop in the colonic blood supply is essential to its development. We encountered a 41-year-old male patient, who presented with abdominal pain and bloody diarrhea. A colonoscopy showed markedly edematous mucosa with tortuous dilatation of the veins and a deep ulceration at the rectosigmoid junction. On an abdominal computed tomography (CT) scan and CT angiography, the mesenteric and splenic veins were absent with numerous venous collaterals for drainage. The patient gradually responded to oral aminosalicylate therapy, and was in remission after nine months. In most cases, non-occlusive ischemic injury is caused by idiopathic form and occlusive ischemia is caused by abnormalities of arteries and acute venous thrombosis. However, chronic venous insufficiency due to obstruction of macrovascular mesenteric vein rarely causes ischemia of the bowel. This report describes the first case of ischemic colitis caused by obstruction of the mesenteric and splenic veins.

  2. Associations of functional alanine-glyoxylate aminotransferase 2 gene variants with atrial fibrillation and ischemic stroke.

    Science.gov (United States)

    Seppälä, Ilkka; Kleber, Marcus E; Bevan, Steve; Lyytikäinen, Leo-Pekka; Oksala, Niku; Hernesniemi, Jussi A; Mäkelä, Kari-Matti; Rothwell, Peter M; Sudlow, Cathie; Dichgans, Martin; Mononen, Nina; Vlachopoulou, Efthymia; Sinisalo, Juha; Delgado, Graciela E; Laaksonen, Reijo; Koskinen, Tuomas; Scharnagl, Hubert; Kähönen, Mika; Markus, Hugh S; März, Winfried; Lehtimäki, Terho

    2016-01-01

    Asymmetric and symmetric dimethylarginines (ADMA and SDMA) impair nitric oxide bioavailability and have been implicated in the pathogenesis of atrial fibrillation (AF). Alanine-glyoxylate aminotransferase 2 (AGXT2) is the only enzyme capable of metabolizing both of the dimethylarginines. We hypothesized that two functional AGXT2 missense variants (rs37369, V140I; rs16899974, V498L) are associated with AF and its cardioembolic complications. Association analyses were conducted using 1,834 individulas with AF and 7,159 unaffected individuals from two coronary angiography cohorts and a cohort comprising patients undergoing clinical exercise testing. In coronary angiography patients without structural heart disease, the minor A allele of rs16899974 was associated with any AF (OR = 2.07, 95% CI 1.59-2.68), and with paroxysmal AF (OR = 1.98, 95% CI 1.44-2.74) and chronic AF (OR = 2.03, 95% CI 1.35-3.06) separately. We could not replicate the association with AF in the other two cohorts. However, the A allele of rs16899974 was nominally associated with ischemic stroke risk in the meta-analysis of WTCCC2 ischemic stroke cohorts (3,548 cases, 5,972 controls) and with earlier onset of first-ever ischemic stroke (360 cases) in the cohort of clinical exercise test patients. In conclusion, AGXT2 variations may be involved in the pathogenesis of AF and its age-related thromboembolic complications. PMID:26984639

  3. Association between clinical features and prognosis of patients with limb-shaking transient ischemic attack

    Institute of Scientific and Technical Information of China (English)

    MA Qing-feng; HUANG Qiang; ZHANG Qian; FAN Chun-qiu; GUO Xiu-hai; WU Jian

    2013-01-01

    Objective This review aims to illustrate the relationship between clinical features and the prognosis of patients with limb-shaking transient ischemic attack (LS-TIA).Data sources Relevant articles published in two main Chinese medical periodical databases (China National Knowledge Infrastructure and China Science Periodical Database) from 1986 to June 2013 were identified with keywords "limb shaking" and "transient ischemic attack".Study selection Original articles and case reports about LS-TIA were selected.Results A total of 63 cases collected from 19 articles were included in the pooled analysis.LS-TIA presented in two cerebrovascular diseases,of which atherosclerotic high-grade stenosis or occlusion in carotid artery system and moyamoya disease formed 95.2% and 4.8%,respectively.Of 63 patients,11 (17.5%) were once misdiagnosed as epileptic and prescribed useless antiepilepsy drugs.The multivariable Logistic regression model showed a significant protective effect of patients with revascularization therapy on prognosis,compared with patients treated with drugs (odds ratio 0.20,95% CI 0.05-0.74,P=0.016).Conclusions Chronic carotid artery system hypoperfusion can induce limb(s) shaking,followed by high possibility of ischemic stroke in the same brain territorial.Revascularization of the responsible artery may work better than conservative drug-based therapy.

  4. Development of an extracellular matrix delivery system for effective intramyocardial injection in ischemic tissue.

    Science.gov (United States)

    Slaughter, Mark S; Soucy, Kevin G; Matheny, Robert G; Lewis, Beecher C; Hennick, Michael F; Choi, Young; Monreal, Gretel; Sobieski, Michael A; Giridharan, Guruprasad A; Koenig, Steven C

    2014-01-01

    Biomaterials with direct intramyocardial injection devices have been developed and are being investigated as a potential cardiac regenerative therapy for end-stage ischemic heart failure. Decellularized extracellular matrix (ECM) has been shown to improve cardiac function and attenuate or reverse pathologic remodeling cascades. CorMatrix Cardiovascular, Inc. has developed a porcine small intestinal submucosa-derived particulate extracellular matrix (P-ECM) and ECM Delivery System to provide uniform and controlled intramyocardial delivery of the injectable P-ECM material into infarcted regions. The CorMatrix ECM Delivery System is composed of a Multi-Needle P-ECM Syringe Assembly, Automated Injection Controller, and Tissue Depth Measurement System (portable ultrasound). Feasibility of the P-ECM delivery system was tested intraoperatively in a chronic ischemic heart failure bovine model (n = 11), and demonstrated the ability to control injection volume (0.1-1.0 ml) and depth of penetration (3-5 mm) under regulated injection pressure (150 psi CO2) into the ischemic region. Targeted intramyocardial delivery of P-ECM may improve efficacy and enable development of novel patient-specific therapy. PMID:25232775

  5. Reconstitution of coronary vasculature by an active fraction of Geum japonicum in ischemic hearts

    Science.gov (United States)

    Chen, Hao; Cheng, Lei; Lin, Xiaoli; Zhou, Xiaping; Cai, Zhiming; Li, Ming

    2014-02-01

    Chronic coronary heart disease (cCHD) is characterized by atherosclerosis, which progressively narrows the coronary artery lumen and impairs myocardial blood flow. Restoration of occluded coronary vessels with newly formed collaterals remains an ideal therapeutic approach due to the need for redirecting blood flow into the ischemic heart. In this study, we investigated the effect of an active fraction isolated from Geum joponicum (AFGJ) on angiogenesis in cCHD hearts. Our results demonstrated that AFGJ not only enhanced capillary tube formation of endothelial cells, but also promoted the growth of new coronary collaterals (at the diameter 0.021-0.21 mm) in the ischemic region of hearts in rat cCHD model. Our study also indicated that the growth of new collaterals in ischemic hearts resulted in improved functional recovery of the cCHD hearts as demonstrated by ECG and echocardiography analyses. These data suggest that AFGJ may provide a novel therapeutic method for effective treatment of cCHD.

  6. Non-ischemic perfusion defects due to delayed arrival of contrast material on stress perfusion cardiac magnetic resonance imaging after coronary artery bypass graft surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Koon; Park, Eun Ah; Park, Sang Joon; Cheon, Gi Jeong; Lee, Whal; Chung, Jin Wook; Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of)

    2014-04-15

    Herein we report about the adenosine stress perfusion MR imaging findings of a 50-year-old man who exhibited two different perfusion defects resulting from two different mechanisms after a coronary artery bypass surgery. An invasive coronary angiography confirmed that one perfusion defect at the mid-anterior wall resulted from an ischemia due to graft stenosis. However, no stenosis was detected on the graft responsible for the mid-inferior wall showing the other perfusion defect. It was assumed that the perfusion defect at the mid-inferior wall resulted from delayed perfusion owing to the long pathway of the bypass graft. The semiquantitative analysis of corrected signal-time curves supported our speculation, demonstrating that the rest-to-stress ratio index of the maximal slope of the myocardial territory in question was similar to those of normal myocardium, whereas that of myocardium with the stenotic graft showed a typical ischemic pattern. A delayed perfusion during long graft pathway in a post-bypass graft patient can mimick a true perfusion defect on myocardial stress MR imaging. Radiologists should be aware of this knowledge to avoid misinterpretation of graft and myocardial status in post bypass surgery patients.

  7. [Ischemic cholangiopathy induced by extended burns].

    Science.gov (United States)

    Cohen, Laurence; Angot, Emilie; Goria, Odile; Koning, Edith; François, Arnaud; Sabourin, Jean-Christophe

    2013-04-01

    Ischemic cholangiopathy is a recently described entity occurring mainly after hepatic grafts. Very few cases after intensive care unit (ICU) for extended burn injury were reported. We report the case of a 73-year-old woman consulting in an hepatology unit, for a jaundice appearing during a hospitalisation in an intensive care unit and increasing from her leaving from ICU, where she was treated for an extended burn injury. She had no pre-existing biological features of biliary disease. Biological tests were normal. Magnetic resonance imaging acquisitions of biliary tracts pointed out severe stenosing lesions of diffuse cholangiopathy concerning intrahepatic biliary tract, mainly peri-hilar. Biopsie from the liver confirmed the diagnosis, showing a biliary cirrhosis with bile infarcts. This case is the fourth case of ischemic cholangiopathy after extended burn injury, concerning a patient without a prior history of hepatic or biliary illness and appearing after hospitalisation in intensive care unit.

  8. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  9. Genetics of ischemic stroke: Indian perspective

    Directory of Open Access Journals (Sweden)

    Subhash Kaul

    2012-01-01

    Full Text Available A stroke is still a major cause of long-term disability and the third largest killer in the world after heart attack and cancer. Inherited genetic variation has been shown to play a role in its pathogenesis and therefore, there is a need to identify the culprit genetic variants. They may provide novel targets for preventive therapeutics. The most intensively investigated candidate gene is PDE4D. There are several positive replication studies of PDE4D gene with stroke. The genetic contribution to ischemic stroke risk in India has not been explored adequately. Reports on few candidate genes are available but we are still lagging behind in this aspect. Most of the reports are from Andhra Pradesh, a province in south India and a few parts of north India. PDE4D has been identified as a predisposition gene for ischemic stroke in Southern as well as the Northern population of India.

  10. Ischemic Stroke during Pregnancy and Puerperium

    OpenAIRE

    Del Zotto, Elisabetta; Giossi, Alessia; Volonghi, Irene; Costa, Paolo; Padovani, Alessandro; Pezzini, Alessandro

    2011-01-01

    Ischemic stroke during pregnancy and puerperium represents a rare occurrence but it could be a serious and stressful event for mothers, infants, and also families. Whenever it does occur, many concerns arise about the safety of the mother and the fetus in relation to common diagnostic tests and therapies leading to a more conservative approach. The physiological adaptations in the cardiovascular system and in the coagulability that accompany the pregnant state, which are more significant arou...

  11. Inflammatory responses in hypoxic ischemic encephalopathy

    OpenAIRE

    Liu, Fudong; McCullough, Louise D.

    2013-01-01

    Inflammation plays a critical role in mediating brain injury induced by neonatal hypoxic ischemic encephalopathy (HIE). The mechanisms underlying inflammatory responses to ischemia may be shared by neonatal and adult brains; however, HIE exhibits a unique inflammation phenotype that results from the immaturity of the neonatal immune system. This review will discuss the current knowledge concerning systemic and local inflammatory responses in the acute and subacute stages of HIE. The key compo...

  12. ENDOTHELIAL DYSFUNCTION IN ISCHEMIC HEART DISEASE

    OpenAIRE

    N. E. Zakirova; R. G. Oganov; A. N. Zakirova; M. P. Plotnikova; G. M. Salakhova

    2016-01-01

    Aim. To assess the role of endothelial vasodilating, vasoconstrictive and adhesive dysfunction in the development of angina pectoris (AP) in patients with ischemic heart disease (IHD).Material and methods. 83 patients with IHD were included in the study. 30 patients had AP of functional class (FC)-II, 27 patients - FC-III and 26 patients - FC-IV. The control group consisted of 25 healthy persons. Bicycle ergometry, daily ECG monitoring and echocardiography were used for verification of IHD. E...

  13. Toll-like receptor 2 deficiency leads to delayed exacerbation of ischemic injury

    Directory of Open Access Journals (Sweden)

    Bohacek Ivan

    2012-08-01

    Full Text Available Abstract Background Using a live imaging approach, we have previously shown that microglia activation after stroke is characterized by marked and long-term induction of the Toll-like receptor (TLR 2 biophotonic signals. However, the role of TLR2 (and potentially other TLRs beyond the acute innate immune response and as early neuroprotection against ischemic injury is not well understood. Methods TLR2−/− mice were subjected to transient middle cerebral artery occlusion followed by different reperfusion times. Analyses assessing microglial activation profile/innate immune response were performed using in situ hybridization, immunohistochemistry analysis, flow cytometry and inflammatory cytokine array. The effects of the TLR2 deficiency on the evolution of ischemic brain injury were analyzed using a cresyl violet staining of brain sections with appropriate lesion size estimation. Results Here we report that TLR2 deficiency markedly affects post-stroke immune response resulting in delayed exacerbation of the ischemic injury. The temporal analysis of the microglia/macrophage activation profiles in TLR2−/− mice and age-matched controls revealed reduced microglia/macrophage activation after stroke, reduced capacity of resident microglia to proliferate as well as decreased levels of monocyte chemotactic protein-1 (MCP-1 and consequently lower levels of CD45high/CD11b+ expressing cells as shown by flow cytometry analysis. Importantly, although acute ischemic lesions (24 to 72 h were smaller in TLR2−/− mice, the observed alterations in innate immune response were more pronounced at later time points (at day 7 after initial stroke, which finally resulted in delayed exacerbation of ischemic lesion leading to larger chronic infarctions as compared with wild-type mice. Moreover, our results revealed that TLR2 deficiency is associated with significant decrease in the levels of neurotrophic/anti-apoptotic factor Insulin-like growth factor-1 (IGF-1

  14. Neurovascular Regulation in the Ischemic Brain

    Science.gov (United States)

    Jackman, Katherine

    2015-01-01

    Abstract Significance: The brain has high energetic requirements and is therefore highly dependent on adequate cerebral blood supply. To compensate for dangerous fluctuations in cerebral perfusion, the circulation of the brain has evolved intrinsic safeguarding measures. Recent Advances and Critical Issues: The vascular network of the brain incorporates a high degree of redundancy, allowing the redirection and redistribution of blood flow in the event of vascular occlusion. Furthermore, active responses such as cerebral autoregulation, which acts to maintain constant cerebral blood flow in response to changing blood pressure, and functional hyperemia, which couples blood supply with synaptic activity, allow the brain to maintain adequate cerebral perfusion in the face of varying supply or demand. In the presence of stroke risk factors, such as hypertension and diabetes, these protective processes are impaired and the susceptibility of the brain to ischemic injury is increased. One potential mechanism for the increased injury is that collateral flow arising from the normally perfused brain and supplying blood flow to the ischemic region is suppressed, resulting in more severe ischemia. Future Directions: Approaches to support collateral flow may ameliorate the outcome of focal cerebral ischemia by rescuing cerebral perfusion in potentially viable regions of the ischemic territory. Antioxid. Redox Signal. 22, 149–160. PMID:24328757

  15. Ischemic Retinal Vasculitis and Its Management

    Directory of Open Access Journals (Sweden)

    Lazha Talat

    2014-01-01

    Full Text Available Ischemic retinal vasculitis is an inflammation of retinal blood vessels associated with vascular occlusion and subsequent retinal hypoperfusion. It can cause visual loss secondary to macular ischemia, macular edema, and neovascularization leading to vitreous hemorrhage, fibrovascular proliferation, and tractional retinal detachment. Ischemic retinal vasculitis can be idiopathic or secondary to systemic disease such as in Behçet’s disease, sarcoidosis, tuberculosis, multiple sclerosis, and systemic lupus erythematosus. Corticosteroids with or without immunosuppressive medication are the mainstay treatment in retinal vasculitis together with laser photocoagulation of retinal ischemic areas. Intravitreal injections of bevacizumab are used to treat neovascularization secondary to systemic lupus erythematosus but should be timed with retinal laser photocoagulation to prevent further progression of retinal ischemia. Antitumor necrosis factor agents have shown promising results in controlling refractory retinal vasculitis excluding multiple sclerosis. Interferon has been useful to control inflammation and induce neovascular regression in retinal vasculitis secondary to Behçet’s disease and multiple sclerosis. The long term effect of these management strategies in preventing the progression of retinal ischemia and preserving vision is not well understood and needs to be further studied.

  16. Hypercholesterolemia in patients of ischemic stroke

    International Nuclear Information System (INIS)

    Background: Stroke is a common neurological disease that results in significant mortality and morbidity globally. Several risk factors have been identified for stroke among which hyperlipidaemia is one of the modifiable risk factors. Recent clinical trials have shown a reduction in ischemic stroke for patients taking lipid lowering medications. Therefore, the aim of this study was to find out the frequency of hypercholesterolemia in patients of ischemic stroke in Hazara region. Method: This cross sectional study was carried out in the Medical Department of Ayub Teaching Hospital, Abbottabad. Ninety patients of stroke confirmed as ischemic by CT scan brain were enrolled in the study after informed consent. The frequency of hypercholesterolemia in patients was recorded. Results: There were 55 (61.1 percentage) males. The mean age of patients was 64.4±11.5 years. The mean serum cholesterol in all patients was 4.16±1.1 mmol/l. The mean serum cholesterol of male patients was 4.3±1.2 mmol/l and 4.0±10.9 mmol/l in the case of females. Conclusions: Hypercholesterolemia could not be established as a major risk factor for stroke in our setup through this study that allude to the fact that other risk factors might be contributing more to the incidence of cerebrovascular accident in our population. (author)

  17. Curcumin protects against ischemic spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Jinhua Zhang; Hao Wei; Meimei Lin; Chunmei Chen; Chunhua Wang; Maobai Liu

    2013-01-01

    Inducible nitric oxide synthase and N-methyl-D-aspartate receptors have been shown to participate in nerve cellinjury during spinal cord ischemia. This study observed a protective effect of curcumin on ischemic spinal cord injury. Models of spinal cord ischemia were established by ligating the lumbar artery from the left renal artery to the bifurcation of the abdominal aorta. At 24 hours after model establishment, the rats were intraperitoneal y injected with curcumin. Reverse transcrip-tion-polymerase chain reaction and immunohistochemical results demonstrated that after spinal cord ischemia, inducible nitric oxide synthase and N-methyl-D-aspartate receptor mRNA and protein expression significantly increased. However, curcumin significantly decreased inducible nitric oxide synthase and N-methyl-D-aspartate receptor mRNA and protein expression in the ischemic spinal cord. Tarlov scale results showed that curcumin significantly improved motor function of the rat hind limb after spinal cord ischemia. The results demonstrate that curcumin exerts a neuroprotective ef-fect against ischemic spinal cord injury by decreasing inducible nitric oxide synthase and N-methyl-D-aspartate receptor expression.

  18. Genetically elevated C-reactive protein and ischemic vascular disease

    DEFF Research Database (Denmark)

    Zacho, J.; Tybjaerg-Hansen, A.; Jensen, J.S.;

    2008-01-01

    in CRP levels of up to 64%, resulting in a theoretically predicted increased risk of up to 32% for ischemic heart disease and up to 25% for ischemic cerebrovascular disease. However, these genotype combinations were not associated with an increased risk of ischemic vascular disease. In contrast......, apolipoprotein E genotypes were associated with both elevated cholesterol levels and an increased risk of ischemic heart disease. Conclusions: Polymorphisms in the CRP gene are associated with marked increases in CRP levels and thus with a theoretically predicted increase in the risk of ischemic vascular disease....... However, these polymorphisms are not in themselves associated with an increased risk of ischemic vascular disease Udgivelsesdato: 2008/10/30...

  19. Cardioprotection by remote ischemic conditioning: Mechanisms and clinical evidences

    Institute of Scientific and Technical Information of China (English)

    Alberto; Aimo; Chiara; Borrelli; Alberto; Giannoni; Luigi; Emilio; Pastormerlo; Andrea; Barison; Gianluca; Mirizzi; Michele; Emdin; Claudio; Passino

    2015-01-01

    In remote ischemic conditioning(RIC), several cycles of ischemia and reperfusion render distant organ and tissues more resistant to the ischemia-reperfusion injury. The intermittent ischemia can be applied before the ischemic insult in the target site(remote ischemic preconditioning), during the ischemic insult(remote ischemic perconditioning) or at the onset of reperfusion(remote ischemic postconditioning). The mechanisms of RIC have not been completely defined yet; however, these mechanisms must be represented by the release of humoral mediators and/or the activation of a neural reflex. RIC has been discovered in the heart, and has been arising great enthusiasm in the cardiovascular field. Its efficacy has been evaluated in many clinical trials, which provided controversial results. Our incomplete comprehension of the mechanisms underlying the RIC could be impairing the design of clinical trials and the interpretation of their results. In the present review we summarize current knowledge about RIC pathophysiology and the data about its cardioprotective efficacy.

  20. A Simplified Technique for Producing an Ischemic Wound Model

    OpenAIRE

    Chien, Sufan; Wilhelmi, Bradon J.

    2012-01-01

    One major obstacle in current diabetic wound research is a lack of an ischemic wound model that can be safely used in diabetic animals. Drugs that work well in non-ischemic wounds may not work in human diabetic wounds because vasculopathy is one major factor that hinders healing of these wounds. We published an article in 2007 describing a rabbit ear ischemic wound model created by a minimally invasive surgical technique. Since then, we have further simplified the procedure for easier operati...

  1. Neonatal ischemic brain injury: what every radiologist needs to know

    Energy Technology Data Exchange (ETDEWEB)

    Badve, Chaitra A.; Khanna, Paritosh C.; Ishak, Gisele E. [Seattle Children' s Hospital, University of Washington Medical Center, Department of Radiology, Seattle, WA (United States)

    2012-05-15

    We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist's perspective. The concept of perinatal stroke is defined and its distinction from hypoxic-ischemic injury is emphasized. A brief review of recent imaging advances is included and a diagnostic approach to neonatal ischemic brain injury is suggested. (orig.)

  2. Ischemic stroke susceptibility gene in a Northern Han Chinese population

    OpenAIRE

    Wang, Haiping; Shi, Shujuan; Yan, Wenjing; Song, Yan; Zhan, Jingjing; Zhang, Chen; Wang, Haiji

    2013-01-01

    Interleukin-18 gene promoter polymorphisms are potential risk factors for ischemic cerebrovascular disease, and the –607C allele may increase ischemic stroke risk in the Han Chinese population. In the present study, we recruited 291 patients with ischemic cerebrovascular disease from the Affiliated Hospital of Qingdao University Medical College, China, and 226 healthy controls. Both patients and controls were from the Han population in northern China. Immunoresonance scattering assays detecte...

  3. Early cerebral hemodynamic, metabolic and histological changes in hypoxic-ischemic fetal lambs during postnatal life

    Directory of Open Access Journals (Sweden)

    Carmen eRey-Santano

    2011-09-01

    Full Text Available The hemodynamic, metabolic and biochemical changes produce during transition from fetal to neonatal life could be aggravated if asphyctic event occur during fetal life. The aim of the study was to examine the regional cerebral blood flow (RCBF, histological changes, and cerebral brain metabolism in preterm lambs, and to analyze the role of oxidative stress for the first hours of postnatal life following severe fetal asphyxia. 18 chronically instrumented fetal lambs were assigned to: hypoxic-ischemic group, following fetal asphyxia animals were delivered and maintained on intermittent-positive-pressure-ventilation for 3 hours, and non-injured animals that were managed similarly to the previous group and used as control group. During hypoxic-ischemic insult, injured group developed acidosis, hypoxia, hypercapnia, latacidaemia and tachycardia in comparison to control group, without hypotension. Intermittent-positive-pressure-ventilation transiently improved gas exchange and cardiovascular parameters. After HI injury and during ventilation-support, the increased RCBF in inner zones was maintained for hypoxic-ischemic group, but cortical flow did not exhibit differences compared to the control group. Also, the increase of TUNEL positive cells (apoptosis and antioxidant enzymes, and decrease of ATP reserves was significantly higher in the brain regions where the RCBF were not increased.In conclusion, early metabolic, histological and hemodynamic changes involved in brain damage have been intensively investigated and reported in premature asphyctic lambs for the first 3 hours of postnatal life. Those changes have been described in human neonates, so our model could be useful to test the security and the effectiveness of different neuroprotective or ventilatory strategies when are applied in the first hours after fetal hypoxic-ischemic injury.

  4. Use of APACHE II and SAPS II to predict mortality for hemorrhagic and ischemic stroke patients.

    Science.gov (United States)

    Moon, Byeong Hoo; Park, Sang Kyu; Jang, Dong Kyu; Jang, Kyoung Sool; Kim, Jong Tae; Han, Yong Min

    2015-01-01

    We studied the applicability of the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in patients admitted to the intensive care unit (ICU) with acute stroke and compared the results with the Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS). We also conducted a comparative study of accuracy for predicting hemorrhagic and ischemic stroke mortality. Between January 2011 and December 2012, ischemic or hemorrhagic stroke patients admitted to the ICU were included in the study. APACHE II and SAPS II-predicted mortalities were compared using a calibration curve, the Hosmer-Lemeshow goodness-of-fit test, and the receiver operating characteristic (ROC) curve, and the results were compared with the GCS and NIHSS. Overall 498 patients were included in this study. The observed mortality was 26.3%, whereas APACHE II and SAPS II-predicted mortalities were 35.12% and 35.34%, respectively. The mean GCS and NIHSS scores were 9.43 and 21.63, respectively. The calibration curve was close to the line of perfect prediction. The ROC curve showed a slightly better prediction of mortality for APACHE II in hemorrhagic stroke patients and SAPS II in ischemic stroke patients. The GCS and NIHSS were inferior in predicting mortality in both patient groups. Although both the APACHE II and SAPS II systems can be used to measure performance in the neurosurgical ICU setting, the accuracy of APACHE II in hemorrhagic stroke patients and SAPS II in ischemic stroke patients was superior.

  5. Fetal myocardium in the kidney capsule: an in vivo model of repopulation of myocytes by bone marrow cells.

    Directory of Open Access Journals (Sweden)

    Eric Y Zhang

    Full Text Available Debate surrounds the question of whether the heart is a post-mitotic organ in part due to the lack of an in vivo model in which myocytes are able to actively regenerate. The current study describes the first such mouse model--a fetal myocardial environment grafted into the adult kidney capsule. Here it is used to test whether cells descended from bone marrow can regenerate cardiac myocytes. One week after receiving the fetal heart grafts, recipients were lethally irradiated and transplanted with marrow from green fluorescent protein (GFP-expressing C57Bl/6J (B6 donors using normal B6 recipients and fetal donors. Levels of myocyte regeneration from GFP marrow within both fetal myocardium and adult hearts of recipients were evaluated histologically. Fetal myocardium transplants had rich neovascularization and beat regularly after 2 weeks, continuing at checkpoints of 1, 2, 4, 6, 8 and12 months after transplantation. At each time point, GFP-expressing rod-shaped myocytes were found in the fetal myocardium, but only a few were found in the adult hearts. The average count of repopulated myocardium with green rod-shaped myocytes was 996.8 cells per gram of fetal myocardial tissue, and 28.7 cells per adult heart tissue, representing a thirty-five fold increase in fetal myocardium compared to the adult heart at 12 months (when numbers of green rod-shaped myocytes were normalized to per gram of myocardial tissue. Thus, bone marrow cells can differentiate to myocytes in the fetal myocardial environment. The novel in vivo model of fetal myocardium in the kidney capsule appears to be valuable for testing repopulating abilities of potential cardiac progenitors.

  6. Intravenously Injected Mesenchymal Stem Cells Home to Infarcted Myocardium Without Altering Cardiac Function

    Institute of Scientific and Technical Information of China (English)

    LI Fei; CHENG Zhao-kang; JIA Xiao-hua; LIU Xiao-lei; LIU Yi; OU Lai-liang; KONG De-ling

    2008-01-01

    Background: Systemic delivery of mesenchymal stem cells (MSCs) to the infarcted myocardium is an attractive noninvasive strategy, but therapeutic effect of this strategy remain highly controversial. Methods: Myocardial infarction was induced in female Sprague-Dawley rats by transient ligation of the left anterior descending coronary artery for 60 min. Either 2.5×106 DiI-labeled MSCs or equivalent saline was injected into the tail vein at 24 h after infarction.Results: Three days later, MSCs localized predominantly in the infarct region of heart rather than in the remote region. MSCs were also observed in spleen, lung and liver. At 4 weeks after infarction, echocardiographic parameters, including ejection fraction, fractional shortening, left ventricular end-diastolic and end-systolic diameters, were not significantly different between MSCs and saline groups. Hemodynamic examination showed that ±dp/dtmax were similar between MSCs and saline-treated animals. Histological evaluation revealed that infarct size and vessel density were not significantly changed by MSCs infusion.Conclusion: Intravenously injected MSCs can home to infarcted myocardium, but plays a limited role in cardiac repair following myocardial infarction.

  7. A connective tissue component of a myocardium: a new stage of studying of an old problem.

    Directory of Open Access Journals (Sweden)

    Gorbunov A.A.

    2007-01-01

    Full Text Available Majority of the myocardial cells belongs to its connective tissue component, which is built up of endomysial, perimysial and epimysial streaks. Cellular population exhibit remarkable polymorphism – among them are different types of fibroblasts, including myofibroblasts and fibroclasts, mast cells, macrophages, lymphoid cells. All of them product biologically active substances and serve as local regulators. Every cardiomyocyte connected merely to one fibroblast by the dense and nexus type of contacts, which allow mechanical and chemical interactions between these cells. Cardiomyocytes and connective tissue cells surrounded by the intercellular matrix, which consists fibrous and amorphous components. Collagen and elastic fibers make a framework for cardiac myocytes, which has a sophisticated spatial arrangement. Amorphous substance is a polyanionic buffer environment that provides trophic and regulatory processes in the myocardium. Intercellular matrix undergo permanent turnover, synthesis of the fiber proteins comes together with its degradation. Hitherto, myocardium is a multicomponent system that has a sophisticated mechanisms of regulation for the quantitative and qualitative composition of its elements.

  8. Phosphorus JCoupling Constants of ATP in Human Myocardium and Calf Muscle

    Science.gov (United States)

    Jung, Wulf-Ingo; Widmaier, Stefan; Seeger, Uwe; Bunse, Michael; Staubert, Andreas; Sieverding, Ludger; Straubinger, Klaus; van Erckelens, Franz; Schick, Fritz; Dietze, Günther; Lutz, Otto

    1996-01-01

    Proton-decoupled31P NMR spectroscopy of the heart and calf muscle of healthy volunteers was performed with a 1.5 T whole-body imager. By use of two-dimensional chemical-shift imaging in combination with slice-selective excitation, well-resolved localized spectra (elements of 38 ml) were obtained within 20 to 35 min from which the homonuclear J coupling constants of ATP could be determined. In myocardium,Jγβ= 16.03 ± 0.17 Hz andJαβ= 15.82 ± 0.23 Hz were obtained, while the values in calf muscle wereJγβ= 17.16 ± 0.12 Hz andJαβ= 16.04 ± 0.09 Hz. The difference inJγβwas significant. According to the literature, a possible reason for greater ATP J coupling constants is a smaller fraction of ATP complexed to magnesium. However, the chemical-shift difference between α- and β-ATP, which is also a measure for the fraction of ATP complexed to magnesium, showed only a small difference in ATP complexation: 88% in myocardium and 90% in calf muscle. This small difference cannot account for the observed difference in Jγβ.

  9. [Contractile reaction of the myocardium of patients with heart diseases to chemical scarification of cell membranes].

    Science.gov (United States)

    Shumakov, V I; Tsyv'ian, P B; Markhasin, V S; Shtengol'd, E Sh

    1978-03-01

    Strips of the myocardium from the auricula atria of patients suffering from mitral stenosis (MS) and septal defects of the heart (SDH) removed during the operation were treated with ethylenediaminetetraacetic acid (DETA)--3mM--to increase the cell membrane permeability (scarification). The mechanical response of the contractile proteins to the change in the Ca2+ was recorded in the ethylene-hexaaminetetraacetic acid (EHTA)--3mM--against the background of increased membrane permeability to the Ca-EHTA complex permitting to regulate Ca2+ concentration in myofibrillae from 10(-9) to 10(-4)M. As shown, with the same threshold concentrations (5.10(-8)M) and saturation concentrations (10(-4)M) of Ca2+ the strips from the patients with MS developed the maximal tension per cross section unit of the strip half as great as the preparations from patients with SDH, this indicating a possible affection of the contractile proteins in the hearts of patients with MS. The ratio between the tension amplitudes under conditions of a complete calcium activation of the contractile proteins and a single isometric contraction for the preparations obtained from the patients with MS was 8 to 10, and with SDH--from 4 to 5. It is supposed that this was the result of more pronounced changes in the apparatus of electromechanical conjugation of the myocardium of patients suffering from MS. PMID:96886

  10. Amelioration of Isoproterenol-Induced Oxidative Damage in Rat Myocardium by Withania somnifera Leaf Extract

    Directory of Open Access Journals (Sweden)

    Md. Ibrahim Khalil

    2015-01-01

    Full Text Available We investigated the protective role of Withania somnifera leaf extract (WSLEt on isoproterenol- (ISO- induced myocardial infarction (MI in rats. Subcutaneous injection of ISO (85 mg/kg body weight (b.w. administered to rats for two consecutive days caused a significant increase in cardiac troponin I (cTnI levels and serum lipid profiles, as well as the activities of some marker enzymes. In addition to these diagnostic markers, there were increased levels of lipid peroxidation (LPO and decreased activities of enzymatic antioxidants (superoxide dismutase (SOD, glutathione peroxidase (GPx, glutathione reductase (GRx, and glutathione-S-transferase (GST in the myocardium. However, oral pretreatment (100 mg/kg b.w. with WSLEt for 4 weeks elicited a significant cardioprotective activity by lowering the levels of cTnI, lipid profiles, and marker enzymes. The levels of LPO products were also significantly decreased. Elevated activities of antioxidant enzymes were also observed in rats pretreated with WSLEt. As further confirmed histopathologically, our findings strongly suggest that the cardioprotective effect of WSLEt on myocardium experiencing ISO-induced oxidative damage may be due to an augmentation of the endogenous antioxidant system and an inhibition of LPO in the myocardial membrane. We conclude that WSLEt confers some protection against oxidative damage in ISO-induced MI in rats.

  11. Myocardium-derived conditioned medium improves left ventricular function in rodent acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Yeh Kuo-Ho

    2011-01-01

    Full Text Available Abstract Background We investigated whether myocardium-derived conditioned medium (MDCM is effective in preserving left ventricular (LV function in a rat acute myocardial infarction (AMI model. Methods Adult male Sprague-Dawley (SD rats (n = 36 randomized to receive either left coronary artery ligation (AMI induction or thoracotomy only (sham procedure were grouped as follows (n = 6 per group: Group I, II, and III were sham-controls treated by fresh medium, normal rat MDCM, and infarct-related MDCM, respectively. Group IV, V, and VI were AMI rats treated by fresh medium, normal MDCM, and infarct-related MDCM, respectively. Either 75 μL MDCM or fresh medium was administered into infarct myocardium, followed by intravenous injection (3 mL at postoperative 1, 12, and 24 h. Results In vitro studies showed higher phosphorylated MMP-2 and MMP-9, but lower α-smooth muscle actin and collagen expressions in neonatal cardiac fibroblasts treated with MDCM compared with those in the cardiac fibroblasts treated with fresh medium (all p Conclusion MDCM therapy reduced cardiac fibrosis and oxidative stress, enhanced angiogenesis, and preserved 90-day LV function in a rat AMI model.

  12. Remodeling in myocardium adjacent to an infarction in the pig left ventricle.

    Science.gov (United States)

    Zimmerman, Scott D; Criscione, John; Covell, James W

    2004-12-01

    Changes in the structure of the "normal" ventricular wall adjacent to an infarcted area involve all components of the myocardium (myocytes, fibroblasts and the extracellular matrix, and the coronary vasculature) and their three-dimensional structural relationship. Assessing changes in these components requires tracking material markers in the remodeling tissue over long periods of time with a three-dimensional approach as well as a detailed histological evaluation of the remodeled structure. The purpose of the present study was to examine the hypotheses that changes in the tissue adjacent to an infarct are related to myocyte elongation, myofiber rearrangement, and changes in the laminar architecture of the adjacent tissue. Three weeks after myocardial infarction, noninfarcted tissue adjacent to the infarct remodeled by expansion along the direction of the fibers and in the cross fiber direction. These changes are consistent with myocyte elongation and myofiber rearrangement (slippage), as well as a change in cell shape to a more elliptical cross section with the major axis in the epicardial tangent plane, and indicate that reorientation of fibers either via "cell slippage" or changes in orientation of the laminar structure of the ventricular wall are quantitatively important aspects of the remodeling of the normally perfused myocardium.

  13. Amelioration of Isoproterenol-Induced Oxidative Damage in Rat Myocardium by Withania somnifera Leaf Extract.

    Science.gov (United States)

    Khalil, Md Ibrahim; Ahmmed, Istiyak; Ahmed, Romana; Tanvir, E M; Afroz, Rizwana; Paul, Sudip; Gan, Siew Hua; Alam, Nadia

    2015-01-01

    We investigated the protective role of Withania somnifera leaf extract (WSLEt) on isoproterenol- (ISO-) induced myocardial infarction (MI) in rats. Subcutaneous injection of ISO (85 mg/kg body weight (b.w.)) administered to rats for two consecutive days caused a significant increase in cardiac troponin I (cTnI) levels and serum lipid profiles, as well as the activities of some marker enzymes. In addition to these diagnostic markers, there were increased levels of lipid peroxidation (LPO) and decreased activities of enzymatic antioxidants (superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GRx), and glutathione-S-transferase (GST)) in the myocardium. However, oral pretreatment (100 mg/kg b.w.) with WSLEt for 4 weeks elicited a significant cardioprotective activity by lowering the levels of cTnI, lipid profiles, and marker enzymes. The levels of LPO products were also significantly decreased. Elevated activities of antioxidant enzymes were also observed in rats pretreated with WSLEt. As further confirmed histopathologically, our findings strongly suggest that the cardioprotective effect of WSLEt on myocardium experiencing ISO-induced oxidative damage may be due to an augmentation of the endogenous antioxidant system and an inhibition of LPO in the myocardial membrane. We conclude that WSLEt confers some protection against oxidative damage in ISO-induced MI in rats.

  14. Temporal delta wave and ischemic lesions on MRI

    International Nuclear Information System (INIS)

    The present study was designed to determine the clinical significance of a temporal low-voltage irregular delta wave (TLID) on EEG. Among 808 EEG records examined during one year at our hospital, the TLID was commonly detected in patients with clinically diagnosed ischemic brain diseases such as multiple infarction. Subsequently, a relation of the TLID to ischemic lesions on MRI was examined in 50 elderly depressive patients. It was found that there was a close correlation between the occurrence of the TLID and small ischemic lesions on MRI (p<0.001). These results suggest that the TLID is a valuable indicator of minor ischemic changes of the brain. (author)

  15. Dietary Curcuma longa protects myocardium against isoproterenol induced hemodynamic, biochemical and histopathological alternations in rats

    Directory of Open Access Journals (Sweden)

    I R Mohanty

    2008-12-01

    Full Text Available Summary: The present study was designed to investigate whether Curcuma longa (Cl, a natural herb, would attenuate the acute myocardial infarction in isoproterenol (ISP-treated rat model via maintaining cardiac function and activities of endogenous antioxidant enzymes. Haemodynamic parameters {systolic, diastolic and mean arterial pressure (SAP, DAP, MAP, heart rate (HR, left ventricular end-diastolic pressure (LVEDP, left ventricular (LV peak positive (+ dP/dt (rate of pressure development and negative  (- dP/dt (rate of pressure decline}were recorded. Cardiac marker enzyme: Creatinine phosphokinase(CPK and antioxidative parameters: Glutathione (GSH, Thiobarbituric acid reactive substances (TBARS, Catalase (CAT, Glutathione peroxidase (GSHPx and Superoxide dismutase (SOD of heart tissues were measured. Histopathological examination of heart tissues was also performed.  Induction of rats with ISP (85 mg/kg on 29th and 30th day, s.c. resulted in significant cardiac necrosis, decline in cardiac function, antioxidant status and elevation in lipid peroxidation. Oral administration of Cl (50, 100 and 200 mg/kg, respectively to healthy experimental animals (i.e. animals without any myocardial pathologic challenge viz. ISP for 30 days significantly enhanced the basal myocardial levels of GSHPx (p<0.05, CAT (p<0.05 activity as compared to the sham group. Subsequent to ISP induced myocardial injury, Cl (100 & 200 mg/kg pre-treatment for 30 days, resulted in significant mitigating effects on several myocardial injury induced biochemical {SOD (p<0.05, CAT(p<0.05, GSHPx(0.05, TBARS (p<0.05, CPK (p<0.05}, hemodynamic {MAP(p<0.05,, LVEDP(p<0.05} and histopathological perturbations. Cl (100 mg/kg was found to be the optimum cardioprotective dose. The results indicate that chronic Cl administration causes myocardial adaptation by augmenting endogenous antioxidants and protects rat hearts from decline in cardiac function and oxidative stress associated with ISP

  16. Ischemic postconditioning protects against ischemic brain injury by up-regulation of acid-sensing ion channel 2a

    Institute of Scientific and Technical Information of China (English)

    Wang-sheng Duanmu; Liu Cao; Jing-yu Chen; Hong-fei Ge; Rong Hu; Hua Feng

    2016-01-01

    Ischemic postconditioning renders brain tissue tolerant to brain ischemia, thereby alleviating ischemic brain injury. However, the exact mechanism of action is still unclear. In this study, a rat model of global brain ischemia was subjected to ischemic postconditioning treat-ment using the vessel occlusion method. After 2 hours of ischemia, the bilateral common carotid arteries were blocked immediately for 10 seconds and then perfused for 10 seconds. This procedure was repeated six times. Ischemic postconditioning was found to mitigate hippocampal CA1 neuronal damage in rats with brain ischemia, and up-regulate acid-sensing ion channel 2a expression at the mRNA and protein level. These ifndings suggest that ischemic postconditioning up-regulates acid-sensing ion channel 2a expression in the rat hippo-campus after global brain ischemia, which promotes neuronal tolerance to ischemic brain injury.

  17. 18F-annexin V apoptosis imaging for detection of myocardium ischemia and reperfusion injury in a rat model

    International Nuclear Information System (INIS)

    18F-annexin V was labeled with 18F-SFB, after size-column exclusion chromatography, the radiochemical purity exceeded 95 %. High focal uptake of 18F-annexin V was visualized in myocardium ischemia-reperfusion injury (RI) area of rat models, which was consistent with autoradiography, the standard uptake values (SUV) of RI was 7.93 ± 3.85, whereas remote viable myocardium was 1.02 ± 0.19 (p 18F-annexin V can be serve as a candidate for the early detection of myocardial ischemia and injury. (author)

  18. Change in C3G protein expression in the peri-infarct myocardium and its significance in rats

    OpenAIRE

    Wang, Li-ping; Li, Gang; Wang, Zhi-Hua; Liu, Xiao-Lan; Wen-ju ZHAO

    2012-01-01

    Objective To investigate the change in expression of C3G protein, a Crk SH3 domain-binding guanine nucleotide-releasing factor, in the peri-infarct myocardium in rats. Methods Male SD rats were randomly divided into experimental myocardial infarction (MI) group and sham-operated (SO) group using Litwin method. The rats in the MI and SO groups were sacrificed at 24 hours and 12 weeks after the operation, and the myocardium was harvested from the cardiac apex in the SO group and the infarct are...

  19. Change in C3G protein expression in the peri-infarct myocardium and its significance in rats

    Directory of Open Access Journals (Sweden)

    Li-ping WANG

    2012-08-01

    Full Text Available Objective To investigate the change in expression of C3G protein, a Crk SH3 domain-binding guanine nucleotide-releasing factor, in the peri-infarct myocardium in rats. Methods Male SD rats were randomly divided into experimental myocardial infarction (MI group and sham-operated (SO group using Litwin method. The rats in the MI and SO groups were sacrificed at 24 hours and 12 weeks after the operation, and the myocardium was harvested from the cardiac apex in the SO group and the infarct area in the MI group for determination of types Ⅰand Ⅲcollagen and C3G protein expression with picric acid-sirius red staining and immunohistochemistry. Non-infarcted myocardium in the MI group and the normal myocardium in the SO group were havrested for measuring the relative expression level of C3G protein by Western blotting. Results The picric acid-sirius red staining showed that typesⅠand Ⅲcollagen volume was respectively 14.01±2.73 and 4.80±0.64 12 weeks after MI, 3.15±0.70 and 1.42±0.48 24 hours after SO, 3.68±0.95 and 1.53±0.61 24 hours after MI, and 3.27±0.65 and 1.47±0.52 (P 0.05. Western blotting revealed that the C3G protein expression 12 weeks after MI was significantly increased compared with that in the other three groups (P 0.05. C3G protein expression in the non-infarct myocardium at 12-week post MI (0.56±0.06, n=8 was significantly higher as compared with that in the cardiac apex 12 weeks (0.22±0.04, n=8, 24 hours (0.22±0.04, n=8 after SO and in the non-infarct myocardium 24 hours after MI (0.29±0.02, n=8 respectively (All P < 0.05. Conclusions C3G protein exists in the myocardium in rats. C3G protein expression could significantly increase in the peri-infarct myocardium. The increased C3G protein expression could be involved in post-infarction cardiac remodeling.

  20. Intravenous Administration of Endothelial Colony-Forming Cells Overexpressing Integrin β1 Augments Angiogenesis in Ischemic Legs.

    Science.gov (United States)

    Goto, Kazuko; Takemura, Genzou; Takahashi, Tomoyuki; Okada, Hideshi; Kanamori, Hiromitsu; Kawamura, Itta; Watanabe, Takatomo; Morishita, Kentaro; Tsujimoto, Akiko; Miyazaki, Nagisa; Ushikoshi, Hiroaki; Kawasaki, Masanori; Mikami, Atsushi; Kosai, Ken-ichiro; Minatoguchi, Shinya

    2016-02-01

    observed in the ischemic leg tissue, even at the chronic stage. Moreover, the cells appeared functional, as evidenced by the improved blood flow. The cell type used (ECFCs), the route of administration (intravenous, not directly injected into the affected area), and the use of ligand-receptor interactions (extracellular matrix and integrins) for homing represent substantial advantages over previously reported cell therapies for the treatment of peripheral artery disease.

  1. beta-adrenoceptor density in chronic infarcted myocardium : a subtype specific decrease of beta(1)-adrenoceptor density

    NARCIS (Netherlands)

    Anthonio, RL; Brodde, OE; van Veldhuisen, DJ; Crijns, HJGM; van Gilst, WH

    2000-01-01

    beta-adrenoceptor density is altered in different cardiac diseases. In heart failure beta-adrenoceptor density is down regulated but in acute myocardial ischemia beta-adrenoceptor density is up regulated. In hearts with myocardial infarction total beta-adrenoceptor density is decreased shortly after

  2. Distinct patterns of constitutive phosphodiesterase activity in mouse sinoatrial node and atrial myocardium.

    Directory of Open Access Journals (Sweden)

    Rui Hua

    Full Text Available Phosphodiesterases (PDEs are critical regulators of cyclic nucleotides in the heart. In ventricular myocytes, the L-type Ca(2+ current (I(Ca,L is a major target of regulation by PDEs, particularly members of the PDE2, PDE3 and PDE4 families. Conversely, much less is known about the roles of PDE2, PDE3 and PDE4 in the regulation of action potential (AP properties and I(Ca,L in the sinoatrial node (SAN and the atrial myocardium, especially in mice. Thus, the purpose of our study was to measure the effects of global PDE inhibition with Isobutyl-1-methylxanthine (IBMX and selective inhibitors of PDE2, PDE3 and PDE4 on AP properties in isolated mouse SAN and right atrial myocytes. We also measured the effects of these inhibitors on I(Ca,L in SAN and atrial myocytes in comparison to ventricular myocytes. Our data demonstrate that IBMX markedly increases spontaneous AP frequency in SAN myocytes and AP duration in atrial myocytes. Spontaneous AP firing in SAN myocytes was also increased by the PDE2 inhibitor erythro-9-[2-hydroxy-3-nonyl] adenine (EHNA, the PDE3 inhibitor milrinone (Mil and the PDE4 inhibitor rolipram (Rol. In contrast, atrial AP duration was increased by EHNA and Rol, but not by Mil. IBMX also potently, and similarly, increased I(Ca,L in SAN, atrial and ventricular myocytes; however, important differences emerged in terms of which inhibitors could modulate I(Ca,L in each myocyte type. Consistent with our AP measurements, EHNA, Mil and Rol each increased I(Ca,L in SAN myocytes. Also, EHNA and Rol, but not Mil, increased atrial I(Ca,L. In complete contrast, no selective PDE inhibitors increased I(Ca,L in ventricular myocytes when given alone. Thus, our data show that the effects of selective PDE2, PDE3 and PDE4 inhibitors are distinct in the different regions of the myocardium indicating important differences in how each PDE family constitutively regulates ion channel function in the SAN, atrial and ventricular myocardium.

  3. Collagen XIV is important for growth and structural integrity of the myocardium.

    Science.gov (United States)

    Tao, Ge; Levay, Agata K; Peacock, Jacqueline D; Huk, Danielle J; Both, Sarah N; Purcell, Nicole H; Pinto, Jose R; Galantowicz, Maarten L; Koch, Manuel; Lucchesi, Pamela A; Birk, David E; Lincoln, Joy

    2012-11-01

    Collagen XIV is a fibril-associated collagen with an interrupted triple helix (FACIT). Previous studies have shown that this collagen type regulates early stages of fibrillogenesis in connective tissues of high mechanical demand. Mice null for Collagen XIV are viable, however formation of the interstitial collagen network is defective in tendons and skin leading to reduced biomechanical function. The assembly of a tightly regulated collagen network is also required in the heart, not only for structural support but also for controlling cellular processes. Collagen XIV is highly expressed in the embryonic heart, notably within the cardiac interstitium of the developing myocardium, however its role has not been elucidated. To test this, we examined cardiac phenotypes in embryonic and adult mice devoid of Collagen XIV. From as early as E11.5, Col14a1(-/-) mice exhibit significant perturbations in mRNA levels of many other collagen types and remodeling enzymes (MMPs, TIMPs) within the ventricular myocardium. By post natal stages, collagen fibril organization is in disarray and the adult heart displays defects in ventricular morphogenesis. In addition to the extracellular matrix, Col14a1(-/-) mice exhibit increased cardiomyocyte proliferation at post natal, but not E11.5 stages, leading to increased cell number, yet cell size is decreased by 3 months of age. In contrast to myocytes, the number of cardiac fibroblasts is reduced after birth associated with increased apoptosis. As a result of these molecular and cellular changes during embryonic development and post natal maturation, cardiac function is diminished in Col14a1(-/-) mice from 3 months of age; associated with dilation in the absence of hypertrophy, and reduced ejection fraction. Further, Col14a1 deficiency leads to a greater increase in left ventricular wall thickening in response to pathological pressure overload compared to wild type animals. Collectively, these studies identify a new role for type XIV

  4. Chronic hypoxia downregulates ZO-2 expression in children with cyanotic congenital heart defect

    OpenAIRE

    Jenkins, Emma L.; Caputo, Massimo; Angelini, Gianni D; Ghorbel, Mohamed

    2016-01-01

    AimsTight junction protein zonula occludens protein 2 (ZO-2) is a member of the membrane-associated guanylate kinases protein family known to be expressed at tight junctions of epithelial and endothelial cells and at adherens junctions (AJs) in cardiomyocytes. Little is known about ZO-2 expression and function in the human heart. Here, we examined the hypothesis that chronic hypoxia down-regulates ZO-2 expression in human myocardium and cultured rat cardiomyocytes.Methods and resultsPatients ...

  5. Mechanisms of post-myocardial infarction healing : from acute survival to chronic remodeling

    OpenAIRE

    Hunt, Darlene L.

    2009-01-01

    Acute survival and chronic healing after myocardial infarction (MI) depend on a myriad of processes that begin within hours of the injury and can continue in the form of remodeling even years thereafter. The myocardium has very little self-renewal capability, and tissue lost to MI is replaced with a collagenous scar. There are currently no clinical therapies that directly target myocardial healing, due in part to the pleiotropic effects and redundancy of signaling factors released after injur...

  6. Effect of myocardial ischemia and nitroglycerin on systolic time intervals in the segmental myocardium

    Directory of Open Access Journals (Sweden)

    Haraoka,Shoichi

    1978-04-01

    Full Text Available Effects of ischemia and nitroglycerin on systolic time intervals in the segmental myocardial length were studied in anesthetized open-chest dogs. Two strain-gauges were sutured on the surface of the left ventricular wall; one was in the central area perfused by the left circumflex coronary artery (LCX and the other was in the area perfused by the left anterior descending coronary artery. LCX was partially occluded with a screw type constrictor to the degree at which reactive hyperemia after the transient total coronary occlusion almost disappeared. After the hemodynamics stabilized nitroglycerin (20 microgram/kg was injected into the femoral vein. In the ischemic area, contraction time was shortened and precontraction time was prolonged in association with an elongation of end-systolic and early systolic segment-length, respectively. The systolic time intervals in the ischemic segment were improved as a result of the recovery in the segment-length toward the control. The results suggest the usefulness of analyzing the segmental myocardial systolic time intervals for verifying the asynchronous contraction of the ventricle and the favourable effects of nitroglycerin on segmental myocardial function in the ischemic area.

  7. 血管生成生长因子治疗缺血性心脏病%Therapeutic Use of Angiogenesis Growth Factors in Ischemic Heart Disease

    Institute of Scientific and Technical Information of China (English)

    朱洪

    2001-01-01

    冠状动脉侧支循环可为缺血心肌供血。血管生成生长因子可诱导血管生成,促进侧支循环建立。血管内皮生长因子、成纤维细胞生长因子已被动物试验、临床试验证明可诱导缺血区侧支循环建立、缓解心绞痛、改善心功能,为缺血性心脏病的治疗提供了新的方法。%The coronary collateral circulation is an alternative source of blood supply to the myocardium jeopardized by failure of the original vessel to provide adequate flow. Angiogenesis growth factors induce angiogenesis to promote collateral circulation, been demonstrated in a number of different animal test and phase Ⅰ clinical experience to induce collateralization in the ischemic area and improve cardiac function. Although there are several unsolved questions, the pharmacologic use of angiogenesis growth factors will represent a viable therapeutic alternative for the patients with ischemic heart disease.

  8. Cardiogenic embolism producing crescendo transient ischemic attacks.

    Science.gov (United States)

    Geraghty, Patrick J; Oak, Jack; Choi, Eric T

    2005-09-01

    Lateralizing, repetitive transient ischemic attacks are characteristic of symptomatic carotid bifurcation atherosclerotic plaques. We report a case in which a cardiogenic embolus, after lodging at the left carotid bifurcation, produced crescendo episodes of expressive aphasia and mild right upper extremity weakness. Complete neurological recovery was achieved following emergent carotid embolectomy and endarterectomy. This case demonstrates that the laminar nature of internal carotid blood flow may result in the localization of embolic events to a single region of the cerebral vasculature, regardless of the source lesion in the carotid artery. The role of endoluminal techniques in the diagnosis and management of such lesions is discussed.

  9. Nitrate administration increases blood flow in dysfunctional but viable myocardium, leading to improved assessment of myocardial viability : A PET study

    NARCIS (Netherlands)

    Slart, Riemer H. J. A.; Agool, Ali; van Veldhuisen, Dirk J.; Dierckx, Rudi A.; Bax, Jeroen J.

    2006-01-01

    SPECT with Tc-99m-labeled agents is better able to detect viability after nitrate administration. Nitrates induce vasoclilation and may increase blood flow to severely hypoperfused but viable myocardium, thereby enhancing tracer delivery and improving the detection of viability. Quantitative data on

  10. Distinction of salvaged and infarcted myocardium within the ischaemic area-at-risk with T2 mapping

    DEFF Research Database (Denmark)

    Hammer-Hansen, Sophia; Ugander, Martin; Hsu, Li-Yueh;

    2014-01-01

    values from T2 maps and signal intensities on T2-weighted images were measured in the corresponding areas. RESULTS: At both imaging time points, the T2 of the salvaged myocardium was longer than of remote (66.0 ± 6.9 vs. 51.4 ± 3.5 ms, P < 0.001 at 4 h, and 56.7 ± 7.3 vs. 48.1 ± 3.5 ms, P < 0.001 at 48 h......AIM: Area-at-risk (AAR) measurements often rely on T2-weighted images, but subtle differences in T2 may be overlooked with this method. To determine the differences in oedema between salvaged and infarcted myocardium, we performed quantitative T2 mapping of the AAR. We also aimed to determine the...... (14.7 ± 5.6 vs. 8.7 ± 5.1 ms, P = 0.02). CONCLUSIONS: T2 relaxation parameters are different in the infarcted and salvaged myocardium, and both are significantly longer than remote. Furthermore, the magnitude of increase in T2 was less in the salvaged myocardium after longer reperfusion, indicating...

  11. Cardiac Magnetic Resonance Imaging in Ischemic Heart Disease

    NARCIS (Netherlands)

    S.W.M. Kirschbaum (Sharon)

    2011-01-01

    textabstractIschemic heart disease is the leading cause of morbidity and mortality in the western world in particularly in the elderly and as medical and revascularization therapy is improving and life expectancy is increasing, the number of patients having ischemic heart disease is expected to incr

  12. Changes of resting cerebral activities in subacute ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Ping Wu

    2015-01-01

    Full Text Available This study aimed to detect the difference in resting cerebral activities between ischemic stroke patients and healthy participants, define the abnormal site, and provide new evidence for pathological mechanisms, clinical diagnosis, prognosis prediction and efficacy evaluation of ischemic stroke. At present, the majority of functional magnetic resonance imaging studies focus on the motor dysfunction and the acute stage of ischemic stroke. This study recruited 15 right-handed ischemic stroke patients at subacute stage (15 days to 11.5 weeks and 15 age-matched healthy participants. A resting-state functional magnetic resonance imaging scan was performed on each subject to detect cerebral activity. Regional homogeneity analysis was used to investigate the difference in cerebral activities between ischemic stroke patients and healthy participants. The results showed that the ischemic stroke patients had lower regional homogeneity in anterior cingulate and left cerebrum and higher regional homogeneity in cerebellum, left precuneus and left frontal lobe, compared with healthy participants. The experimental findings demonstrate that the areas in which regional homogeneity was different between ischemic stroke patients and healthy participants are in the cerebellum, left precuneus, left triangle inferior frontal gyrus, left inferior temporal gyrus and anterior cingulate. These locations, related to the motor, sensory and emotion areas, are likely potential targets for the neural regeneration of subacute ischemic stroke patients.

  13. Nonfasting glucose, ischemic heart disease, and myocardial infarction

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjaerg-Hansen, Anne; McCarthy, Mark I;

    2012-01-01

    The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI).......The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI)....

  14. Ischemic Preconditioning of One Forearm Enhances Static and Dynamic Apnea

    DEFF Research Database (Denmark)

    Kjeld, Thomas; Rasmussen, Mads Reinholdt; Jattu, Timo;

    2014-01-01

    INTRODUCTION: Ischemic preconditioning enhances ergometer cycling and swimming performance. We evaluated whether ischemic preconditioning of one forearm (four times for 5 min) also affects static breath hold and underwater swimming, whereas the effect of similar preconditioning on ergometer rowin...... preparation for physical activity....... preconditioning reduced the forearm oxygen saturation from 65% ± 7% to 19% ± 7% (mean ± SD; P

  15. Perceived stress and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Kristensen, Tage Søndergård; Prescott, Eva;

    2006-01-01

    It is unclear whether the commonly recognized link between stress and cardiovascular disease is causal or the result of reporting bias. The objective of this study was to address the association between perceived stress and first incidence of ischemic heart disease and to evaluate the suggested...... reporting bias by addressing subdiagnoses of ischemic heart disease separately....

  16. Glibenclamide for the Treatment of Ischemic and Hemorrhagic Stroke

    OpenAIRE

    Nicholas Caffes; Kurland, David B.; Volodymyr Gerzanich; J. Marc Simard

    2015-01-01

    Ischemic and hemorrhagic strokes are associated with severe functional disability and high mortality. Except for recombinant tissue plasminogen activator, therapies targeting the underlying pathophysiology of central nervous system (CNS) ischemia and hemorrhage are strikingly lacking. Sur1-regulated channels play essential roles in necrotic cell death and cerebral edema following ischemic insults, and in neuroinflammation after hemorrhagic injuries. Inhibiting endothelial, neuronal, astrocyti...

  17. Complications of hemorrhagic and ischemic stroke : a CT perfusion evaluation

    NARCIS (Netherlands)

    Dankbaar, J.W.

    2010-01-01

    In this thesis the use of CT-perfusion (CTP) imaging in the evaluation of the most severe complications of subarachnoid hemorrhage (SAH)) and ischemic stroke was explored. These complications are delayed cerebral ischemia (DCI) after SAH and damage to the blood-brain barrier (BBB) after ischemic str

  18. Changes of resting cerebral activities in subacute ischemic stroke patients

    Institute of Scientific and Technical Information of China (English)

    Ping Wu; Fang Zeng; Yong-xin Li; Bai-li Yu; Li-hua Qiu; Wei Qin; Ji Li; Yu-mei Zhou; Fan-rong Liang

    2015-01-01

    This study aimed to detect the difference in resting cerebral activities between ischemic stroke pa-tients and healthy participants, deifne the abnormal site, and provide new evidence for pathological mechanisms, clinical diagnosis, prognosis prediction and efifcacy evaluation of ischemic stroke. At present, the majority of functional magnetic resonance imaging studies focus on the motor dysfunc-tion and the acute stage of ischemic stroke. This study recruited 15 right-handed ischemic stroke patients at subacute stage (15 days to 11.5 weeks) and 15 age-matched healthy participants. A rest-ing-state functional magnetic resonance imaging scan was performed on each subject to detect cerebral activity. Regional homogeneity analysis was used to investigate the difference in cerebral activities between ischemic stroke patients and healthy participants. The results showed that the ischemic stroke patients had lower regional homogeneity in anterior cingulate and left cerebrum and higher regional homogeneity in cerebellum, left precuneus and left frontal lobe, compared with healthy participants. The experimental ifndings demonstrate that the areas in which regional homogeneity was different between ischemic stroke patients and healthy participants are in the cerebellum, left precuneus, left triangle inferior frontal gyrus, left inferior temporal gyrus and anterior cingulate. These locations, related to the motor, sensory and emotion areas, are likely po-tential targets for the neural regeneration of subacute ischemic stroke patients.

  19. N-13 ammonia myocardial positron computed tomography, (2). Evaluation of serial change in the lung and the myocardium

    Energy Technology Data Exchange (ETDEWEB)

    Tamaki, Nagara; Senda, Michio; Yonekura, Yoshiharu

    1985-02-01

    To assess temporal change of the tracer, dynamic study of cardiac positron computed tomography (PCT) was performed in 13 cases. Immediately after intravenous bolus injection of 10-20 mCi of N-13 labeled ammonia, sequential 15 seconds sampling was done for 3 minutes (early dynamic scan) and serial 5 minutes sampling was done for another 30 minutes (late dynamic scan). From the early dynamic scan, the time activity curves of the blood-pool, the lung, and the myocardium were obtained to calculate half time of the lung washout curve (L-T 1/2) and peak time of the myocardium (M-peak). From the late dynamic scan, % increase in regional myocardium in 30 minutes was calculated. In 3 normal cases, the blood-pool image was obtained in the first scan, and the left ventricular myocardium was visualized from the third scan. L-T1/2 was 50 +- 4.1 sec and M-peak was 50 +- 18.7 sec. In 7 cases with myocardial infraction, early dynamic scan showed delayed appearance of the myocardium (M-peak: 99 +- 47.9 sec) with prolonged pulmonary uptake (L-T 1/2: 159 +- 80 sec), suggesting pulmonary congestion. Similar results were obtained in a case with mitral stenosis (L-T 1/2: 300 sec; M-peak: 225 sec). Delayed dynamic scan was performed in 3 normal cases and 5 cases with myocardial infarction. % increase in the myocardial activity was 25.1 +- 6.8% in normal cases, 26.1 +- 11.1% in normal segments in infarct cases, and 21.6 +- 16.9% in infarct segments. Furthermore, 5 of 14 infarct segments (36%) showed less than 10% increase while increased myocardial activity in 9 infarct segments (64%), suggesting different pathophysiology in these segments. We conclude that our PCT permits serial dynamic study of the heart, which provides useful information of the tracer kinetics of the lung and the myocardium as well as of the pathophysiology of the myocardium.

  20. Mechanisms and application of mesenchymal stem cells in ischemic heart disease%骨髓间充质干细胞在缺血性心脏病中的作用机制及其应用

    Institute of Scientific and Technical Information of China (English)

    李林岭

    2011-01-01

    缺血性心脏病是一类严重危害人类健康的疾病.在积极开展各种药物和介入治疗的同时,细胞疗法已成为当下心血管领域的一大热点,骨髓间充质干细胞通过移植或骨髓动员至缺血心脏后能有效改善急性心肌梗死患者短期的心功能.本文就骨髓间充质干细胞疗法在缺血性心脏病中的作用机制及其应用的最新研究成果作一综述.%Ischemic heart disease is a great threat to human health. Besides the drugs and interventional therapy, cell therapy has been becoming a hot topic in cardiovascular field. Bone marrow mesenchymal stem cells (MSCs) could improve the short-term cardiac function of patients with acute myocardial infarction when MSCs were transplanted or mobilized into the ischemic myocardium. This review summarized the latest advances in the mechanisms and application of MSCs in ischemic heart disease.

  1. In situ electrostimulation drives a regenerative shift in the zone of infarcted myocardium.

    Science.gov (United States)

    Spadaccio, Cristiano; Rainer, Alberto; De Marco, Federico; Lusini, Mario; Gallo, Paolo; Sedati, Pietro; Muda, Andrea Onetti; De Porcellinis, Stefano; Gregorj, Chiara; Avvisati, Giuseppe; Trombetta, Marcella; Chello, Massimo; Covino, Elvio; Bull, David A; Patel, Amit N; Genovese, Jorge A

    2013-01-01

    Electrostimulation represents a well-known trophic factor for different tissues. In vitro electrostimulation of non-stem and stem cells induces myogenic predifferentiation and may be a powerful tool to generate cells with the capacity to respond to local areas of injury. We evaluated the effects of in vivo electrostimulation on infarcted myocardium using a miniaturized multiparameter implantable stimulator in rats. Parameters of electrostimulation were organized to avoid a direct driving or pacing of native heart rhythm. Electrical stimuli were delivered for 14 days across the scar site. In situ electrostimulation used as a cell-free, cytokine-free stimulation system, improved myocardial function, and increased angiogenesis through endothelial progenitor cell migration and production of vascular endothelial growth factor (VEGF). In situ electrostimulation represents a novel means to stimulate repair of the heart and other organs, as well as to precondition tissues for treatment with cell-based therapies.

  2. Second-harmonic generation imaging of collagen fibers in myocardium for atrial fibrillation diagnosis

    Science.gov (United States)

    Tsai, Ming-Rung; Chiu, Yu-Wei; Lo, Men Tzung; Sun, Chi-Kuang

    2010-03-01

    Atrial fibrillation (AF) is the most common irregular heart rhythm and the mortality rate for patients with AF is approximately twice the mortality rate for patients with normal sinus rhythm (NSR). Some research has indicated that myocardial fibrosis plays an important role in predisposing patients to AF. Therefore, realizing the relationship between myocardial collagen fibrosis and AF is significant. Second-harmonic generation (SHG) is an optically nonlinear coherent process to image the collagen network. We perform SHG microscopic imaging of the collagen fibers in the human atrial myocardium. Utilizing the SHG images, we can identify the differences in morphology and the arrangement of collagen fibers between NSR and AF tissues. We also quantify the arrangement of the collagen fibers using Fourier transform images and calculating the values of angle entropy. We indicate that SHG imaging, a nondestructive and reproducible method to analyze the arrangement of collagen fibers, can provide explicit information about the relationship between myocardial fibrosis and AF.

  3. Genetics of Atrial Fibrillation and Possible Implications for Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Robin Lemmens

    2011-01-01

    Full Text Available Atrial fibrillation is the most common cardiac arrhythmia mainly caused by valvular, ischemic, hypertensive, and myopathic heart disease. Atrial fibrillation can occur in families suggesting a genetic background especially in younger subjects. Additionally recent studies have identified common genetic variants to be associated with atrial fibrillation in the general population. This cardiac arrhythmia has important public health implications because of its main complications: congestive heart failure and ischemic stroke. Since atrial fibrillation can result in ischemic stroke, one might assume that genetic determinants of this cardiac arrhythmia are also implicated in cerebrovascular disease. Ischemic stroke is a multifactorial, complex disease where multiple environmental and genetic factors interact. Whether genetic variants associated with a risk factor for ischemic stroke also increase the risk of a particular vascular endpoint still needs to be confirmed in many cases. Here we review the current knowledge on the genetic background of atrial fibrillation and the consequences for cerebrovascular disease.

  4. Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis

    DEFF Research Database (Denmark)

    Schmitz, Marie Louise; Simonsen, Claus Z; Hundborg, Heidi;

    2014-01-01

    BACKGROUND AND PURPOSE: Data on long-term outcome after intravenous tissue-type plasminogen activator (tPA) in ischemic stroke are limited. We examined the risk of long-term mortality, recurrent ischemic stroke, and major bleeding, including intracranial and gastrointestinal bleeding......, in intravenous tPA-treated patients when compared with intravenous tPA eligible but nontreated patients with ischemic stroke. METHODS: We conducted a register-based nationwide propensity score-matched follow-up study among patients with ischemic stroke in Denmark (2004-2011). Cox regression analysis was used...... to compute adjusted hazard ratios for all outcomes. RESULTS: Among 4292 ischemic strokes (2146 intravenous tPA-treated and 2146 propensity score-matched nonintravenous tPA-treated patients), with a follow-up for a median of 1.4 years, treatment with intravenous tPA was associated with a lower risk of long...

  5. improvement of chronic heart failure by dexamethasone is not associated with downregulation of leptin in rats

    Institute of Scientific and Technical Information of China (English)

    Qin-gui XIA; Tao NA; Yi-min GUO; Yun-tian BI; Hai-yan ZHANG; De-zai DAI

    2007-01-01

    Aim: To demonstrate the hypothesis that dexamethasone (Dex) could improve chronic heart failure (CHF) by inhibiting the downstream signaling transduction of leptin but had no influence on the upregulation of leptin and its receptor in myocardium. Methods: CHF was induced by left coronary artery ligation for 6weeks. CHF rats were treated with Dex 50 mg.kg-1.d-1. Hemodynamics, histology,reactive oxygen species (ROS)-related parameters, and leptin concentrations in serum were measured. The mRNA expression of matrix metalloproteinases (MMP)2/9, tissue inhibitor of metalloproteinases (TIMP)1/2, tumor necrosis factor (TNF)-α, and OB-Rb were measured by RT-PCR. Results: In the CHF rats, hemodynamic functions were deteriorated, which was accompanied with myocardium remodel-ing and histological changes. CHF rats showed hyperleptinemia and excessive ROS in the serum, and the upregulation of MMP-2/9, TNF-α, and leptin receptorm RNA and downregulation of TIMP-1/2 mRNA in the myocardium compared with the sham operation group. Dex treatment significantly ameliorated CHF in association with the reversion of the abnormalities of MMP-2/9, TIMP-1/2, TNF-α, and ROS. But Dex had no influence on the hyperleptinemia and the upregulated leptin and its receptor in the myocardium during CHF. Conclusion: Dex improves CHF by inhibiting TNF-α, MMP-2, MMP-9, and ROS. Dex had no effects on upregulated leptin and its receptor expression and hyperleptinemia induced by CHF.

  6. Transplantation of genetically engineered cardiac fibroblasts producing recombinant human erythropoietin to repair the infarcted myocardium

    Directory of Open Access Journals (Sweden)

    Ruvinov Emil

    2008-11-01

    Full Text Available Abstract Background Erythropoietin possesses cellular protection properties. The aim of the present study was to test the hypothesis that in situ expression of recombinant human erythropoietin (rhEPO would improve tissue repair in rat after myocardial infarction (MI. Methods and results RhEPO-producing cardiac fibroblasts were generated ex vivo by transduction with retroviral vector. The anti-apoptotic effect of rhEPO-producing fibroblasts was evaluated by co-culture with rat neonatal cardiomyocytes exposed to H2O2-induced oxidative stress. Annexin V/PI assay and DAPI staining showed that compared with control, rhEPO forced expression markedly attenuated apoptosis and improved survival of cultured cardiomyocytes. To test the effect of rhEPO on the infarcted myocardium, Sprague-Dawley rats were subjected to permanent coronary artery occlusion, and rhEPO-producing fibroblasts, non-transduced fibroblasts, or saline, were injected into the scar tissue seven days after infarction. One month later, immunostaining identified rhEPO expression in the implanted engineered cells but not in controls. Compared with non-transduced fibroblasts or saline injection, implanted rhEPO-producing fibroblasts promoted vascularization in the scar, and prevented cell apoptosis. By two-dimensional echocardiography and postmortem morphometry, transplanted EPO-engineered fibroblasts did not prevent left ventricular (LV dysfunction and adverse LV remodeling 5 and 9 weeks after MI. Conclusion In situ expression of rhEPO enhances vascularization and reduces cell apoptosis in the infarcted myocardium. However, local EPO therapy is insufficient for functional improvement after MI in rat.

  7. iPSC-derived human mesenchymal stem cells improve myocardial strain of infarcted myocardium.

    Science.gov (United States)

    Miao, Qingfeng; Shim, Winston; Tee, Nicole; Lim, Sze Yun; Chung, Ying Ying; Ja, K P Myu Mia; Ooi, Ting Huay; Tan, Grace; Kong, Geraldine; Wei, Heming; Lim, Chong Hee; Sin, Yoong Kong; Wong, Philip

    2014-08-01

    We investigated global and regional effects of myocardial transplantation of human induced pluripotent stem cell (iPSC)-derived mesenchymal stem cells (iMSCs) in infarcted myocardium. Acute myocardial infarction (MI) was induced by ligation of left coronary artery of severe combined immunodeficient mice before 2 × 10(5) iMSCs or cell-free saline were injected into peri-infarcted anterior free wall. Sham-operated animals received no injection. Global and regional myocardial function was assessed serially at 1-week and 8-week by segmental strain analysis by using two dimensional (2D) speckle tracking echocardiography. Early myocardial remodelling was observed at 1-week and persisted to 8-week with global contractility of ejection fraction and fractional area change in saline- (32.96 ± 14.23%; 21.50 ± 10.07%) and iMSC-injected (32.95 ± 10.31%; 21.00 ± 7.11%) groups significantly depressed as compared to sham control (51.17 ± 11.69%, P myocardial dilatation was observed in saline-injected animals (4.40 ± 0.62 mm, P strain analysis showed significant improved basal anterior wall strain (28.86 ± 8.16%, P strain only in saline-injected (21.50 ± 5.31%, P myocardial strain coincided with the presence of interconnecting telocytes in interstitial space of the infarcted anterior segment of the heart. Our results show that localized injection of iMSCs alleviates ventricular remodelling, sustains global and regional myocardial strain by paracrine-driven effect on neoangiogenesis and myocardial deformation/compliance via parenchymal and interstitial cell interactions in the infarcted myocardium.

  8. Furosemide modifies heart hypertrophy and glycosaminoglycan myocardium content in a rat model of neurogenic hypertension.

    Science.gov (United States)

    Pourzitaki, Chryssa; Tsaousi, Georgia; Manthou, Maria Eleni; Karakiulakis, Georgios; Kouvelas, Dimitrios; Papakonstantinou, Eleni

    2016-08-01

    Hypertension is a major risk factor for atherogenesis and heart hypertrophy, both of which are associated with specific morphological and functional changes of the myocardium. Glycosaminoglycans (GAGs) are complex molecules involved both in tissue morphology and function. In the present study, we investigated the effects of neurogenic hypertension and subsequent antihypertensive treatment with furosemide, on heart hypertrophy and the content of GAGs in the myocardium. Neurogenic hypertension was achieved in male Wistar rats by bilateral aortic denervation (bAD). At days 2, 7 and 15 after surgery, animals were sacrificed and the hearts were dissected away, weighted, and homogenized. Total GAGs were assessed by measuring the uronic acid content colorimetrically and individual GAGs were isolated and characterized by enzymatic treatment, with GAG-degrading enzymes, using electrophoresis on polyacrylamide gradient gels and cellulose acetate membranes. In bAD-animals blood pressure, blood pressure lability, heart rate and heart weight were significantly increased 15 days postoperatively. These effects were prevented by treatment with furosemide. Major GAGs identified in the heart were chondroitin sulphates, heparin (H), heparan sulphate (HS) and hyaluronic acid. The content of uronic and the relative content of H and HS in the heart in bAD animals significantly decreased from day 2 to day 15 postoperatively. Furosemide prevented the bAD induced decrease in GAG content. Considering that H and HS are potent inhibitors of cardiomyocyte hypertrophy, our results indicate that heart hypertrophy induced by neurogenic hypertension may be associated with decreases in the relative content of heparin and heparan sulphate in the heart. PMID:27221775

  9. Control of calcium transport in the myocardium by the cyclic AMP-Protein kinase system.

    Science.gov (United States)

    Katz, A M; Tada, M; Kirchberger, M A

    1975-01-01

    At least three mechanical changes characterize the response of cardiac muscle to agents that enhance cyclic AMP production. In common with other inotropic interventions, tension is augmented and the rate of tension rise is increased. The third response, acceleration of the rate of relaxation, is characteristic of the actions of beta-adrenergic agonists. These mechanical effects can be attributed to changes in (1) the amount of Ca2+ released during systole, (2) the rate of Ca2+ release at the onset of systole, and (3) the rate at which Ca2+ is reaccumulated by the sarcoplasmic reticulum at the end of systole. The ability of cyclic AMP-dependent protein kinases to phosphorylate the cardiac sarcoplasmic reticulum in vitro parallels stimulation of both Ca2+ transport and Ca2+-activated ATPase. The phosphoprotein formed in the presence of cyclic AMP and protein kinase has the chemical characteristics of a phosphoester, contains mostly phosphoserine, and has an electrophoretic mobility in SDS polyacrylamide gels that corresponds to a protein of 22,000 daltons. This 22,000-dalton protein, tentatively named phospholamban, thus differs from the acyl phosphooprotein formed by the Ca2+-transport ATPase, which as an apparent molecular weight of 90,000 to 100,000 daltons. Phospholamban has not been found in fast skeletal muscle, nor is Ca2+ transport accelerated by cyclic AMP and protein kinase in sarcoplasmic reticulum from these muslces which do not respond to beta-adrenergic agonists with accelerated relaxation. It thus appears likely that phosphorylation of phospholamban correlates both with an increased rate of Ca2+ transport by cardiac sarcoplasmic reticulum in vitro and accelerated relaxation in the intact myocardium. Preliminary findings are consistent with the view that phosphorylation of phospholamban may be related to other actions on Ca2+ fluxes brought about by agents which activate adenylate cyclase in the myocardium, but these interpretations must remain

  10. Pathological study on right atrium myocardium in rheumatic heart disease patients with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    DUAN Xiang-ying; ZHANG Bao-ren; LI Li

    2002-01-01

    Objective:To study the pathological basis of right atrial fibrillation in rheumatic heart disease (RHD) patients with atrial fibrillation (AF). Methods: Twenty-nine patients with mitral valve replacement of RHD were divided into AF group (n= 13) and sinus rhythm group (SN group) (n= 16). There was no significant statistical difference in clinical factors between the 2 groups. During the operation of valve replacement, the samples of right atrial appendages were taken and the qualitative and quantitative study were made by light microscopy and electron microscopy. Results: (1) Light microscope: The interstitial fibrosis and the arrangement of myocardium was more disordered in AF group than that in SN group. However, no statistic difference was found in interstitial fibrosis and cellar hypertrophy degree between the 2 groups. (2) Electron microscope: Mitochondrial crosta broke and dissolved obviously in AF group. The mitochondrial volume in AF group was smaller than that in SN group. Volume density, average area and average perimeter in AF group were less than that in SN group; specific surface in AF group was bigger than that in SN group. There was significant difference of above factors between the 2 groups; but there was no significant difference of surface density and numerical density on area in the 2 groups. Volume density of myofibril in AF group and SN group were less than that in SN group. (3)Split of Intercalated disc(ID) gap was found in AF group, and there was marrowing and floccular substance in ID gap. Conclusion: There were significant differences in the pathological changes of right atrial myocardium between AF and SN with RHD, these changes may be the important pathological basis for RA fibrillation of AF patients with RHD.

  11. Sympathetic re-innervation of myocardium after liver transplant in the hereditary amyloid neuropathy

    International Nuclear Information System (INIS)

    The hereditary amyloid neuropathy (HAN) is characterized by a progressive sensory-motor poly-neuropathy and a dysautonomia with myocardium sympathetic denervation. This is established by MIBL scintigraphy and may enhance the troubles of conduction and of cardiac rhythm. The amyloid deposits are constituted of anomalous pre-albumin fabricated by liver. The hepatic transplant (HT) is the only known treatment. Four patients (GI: 39 ± 5 years) have been studied by MIBG scintigraphy, 2.2 ± 0.7 years after HT, and compared with 12 patients (GII: 39 ± 12 years) studied before HT. The left ventricular function, the coronary arteries and the at-rest scintigraphy with thallium were normal for all of them. The cardiac capture of MIBG, evaluated by the cardio-mediastinal activity ratio (C/M), measured on an anterior thoracic planar acquisition performed 4 hours after the intravenous injection of 300 MBq, was higher for GI than for GII (1.49 ± 0.12 vs 1.29 ± 0.13, p 0.02). The washouts (4 h / 20 min) were not different. In tomography, the patients of GI presented focal anomalies with a more-or-less extended apical defect, a satisfying fixation of the basal half of the anterior wall, more-or-less overflowing the septal and lateral walls, and for 2 patients, a satisfying inferior fixation. On the contrary, 9/12 patients of GII have had a diffuse absence of fixation, the other three heaving a satisfying antero-basal fixation (χ2, p = 0.05). The results are not explained by difference of severity or evolution duration of HAN. Thus, it appears that there exists a sympathetic re-innervation of myocardium after HT in the HAN, debuting by the heart base, similarly with the effect of anatomic interruption of innervation in cardiac transplants

  12. Intravenous thrombolysis, mechanical embolectomy, and intracranial stenting for hyperacute ischemic stroke in a patient with moyamoya disease.

    Science.gov (United States)

    Argetsinger, Debora S; Miller, Jeffrey W; Fletcher, Jeffrey J

    2016-07-01

    The Japanese translation of moyamoya means "puff of smoke" and refers to the angiographic appearance of dilated collateral vessels seen during chronic progressive narrowing of the intracranial supraclinoid portions of the internal carotid arteries. Despite cerebral ischemia being the most common presenting symptom, 20% to 40% of adults suffer a hemorrhagic stroke. Due to the lack of evidence and histopathologic findings, intravenous and endovascular reperfusion therapy is typically avoided. This case study presents a patient with moyamoya disease in the hyperacute phase of ischemic stroke. The patient received full dose (0.9mg/kg) tissue plasminogen activator and subsequently underwent a mechanical clot extraction and Wingspan stent (Stryker, Kalamazoo, MI, USA) placement. The use of these options in the setting of moyamoya disease is novel. This demonstrates that moyamoya disease may not be an absolute contraindication to revascularization in hyperacute ischemic stroke and underscores that many perceived contraindications to thrombolytic and mechanical revascularization therapies are relative. PMID:26896911

  13. Prevalence of electrocardiographic ST-T changes during acute ischemic stroke in patients without known ischemic heart disease

    DEFF Research Database (Denmark)

    Jensen, Jesper K; Bak, Søren; Flemming Høilund-Carlsen, Poul;

    2008-01-01

    We evaluated characteristics and prevalence of ST-segment depression and/or T-wave inversion in the resting electrocardiogram of 244 consecutive patients with acute ischemic stroke, but without ischemic heart disease. The prevalence of ST-T changes ranged from 13% to 16% and this is what to expect...

  14. Diagnosing Paroxysmal Atrial Fibrillation in Patients With Ischemic Strokes and Transient Ischemic Attacks Using Echocardiographic Measurements of Left Atrium Function

    DEFF Research Database (Denmark)

    Skaarup, Kristoffer Grundtvig; Christensen, Hanne; Høst, Nis;

    2016-01-01

    AF in patients with ischemic stroke (IS) and transient ischemic attack (TIA). We retrospectively analyzed 219 patients who after acute IS or TIA underwent a transthoracic echocardiographic examination. Patients were designated as patients with paroxysmal AF if they had one or more reported incidents...

  15. Creatine kinase in ischemic and inflammatory disorders.

    Science.gov (United States)

    Kitzenberg, David; Colgan, Sean P; Glover, Louise E

    2016-12-01

    The creatine/phosphocreatine pathway plays a conserved and central role in energy metabolism. Compartmentalization of specific creatine kinase enzymes permits buffering of local high energy phosphates in a thermodynamically favorable manner, enabling both rapid energy storage and energy transfer within the cell. Augmentation of this metabolic pathway by nutritional creatine supplementation has been shown to elicit beneficial effects in a number of diverse pathologies, particularly those that incur tissue ischemia, hypoxia or oxidative stress. In these settings, creatine and phosphocreatine prevent depletion of intracellular ATP and internal acidification, enhance post-ischemic recovery of protein synthesis and promote free radical scavenging and stabilization of cellular membranes. The creatine kinase energy system is itself further regulated by hypoxic signaling, highlighting the existence of endogenous mechanisms in mammals that can enhance creatine metabolism during oxygen deprivation to promote tissue resolution and homeostasis. Here, we review recent insights into the creatine kinase pathway, and provide rationale for dietary creatine supplementation in human ischemic and inflammatory pathologies. PMID:27527620

  16. Biomarkers of Hypoxic Ischemic Encephalopathy in Newborns

    Directory of Open Access Journals (Sweden)

    Martha V. Douglas-Escobar

    2012-11-01

    Full Text Available As neonatal intensive care has evolved, the focus has shifted from improving mortality alone to an effort to improve both mortality and morbidity. The most frequent source of neonatal brain injury occurs as a result of hypoxic-ischemic injury. Hypoxic-ischemic injury occurs in about 2 of 1,000 full-term infants and severe injured infants will have lifetime disabilities and neurodevelopmental delays. Most recently, remarkable efforts toward neuroprotection have been started with the advent of therapeutic hypothermia and a key step in the evolution of neonatal neuroprotection is the discovery of biomarkers that enable the clinician-scientist to screen infants for brain injury, monitor progression of disease, identify injured brain regions, and assess efficacy of neuroprotective clinical trials. Lastly, biomarkers offer great hope identifying when an injury occurred shedding light on the potential pathophysiology and the most effective therapy. In this article, we will review biomarkers of HIE including S100b, neuron specific enolase, umbilical cord IL-6, CK-BB, GFAP, myelin basic protein, UCHL-1, and pNF-H. We hope to contribute to the awareness, validation and clinical use of established as well as novel neonatal brain injury biomarkers.

  17. Metabolic Prosthesis for Oxygenation of Ischemic Tissue

    Energy Technology Data Exchange (ETDEWEB)

    Greenbaum, Elias [ORNL

    2009-01-01

    This communication discloses new ideas and preliminary results on the development of a "metabolic prosthesis" for local oxygenation of ischemic tissue under physiological neutral conditions. We report for the first time the selective electrolysis of physiological saline by repetitively pulsed charge-limited electrolysis for the production of oxygen and suppression of free chlorine. For example, using 800 A amplitude current pulses and <200 sec pulse durations, we demonstrated prompt oxygen production and delayed chlorine production at the surface of a shiny 0.85 mm diameter spherical platinum electrode. The data, interpreted in terms of the ionic structure of the electric double layer, suggest a strategy for in situ production of metabolic oxygen via a new class of "smart" prosthetic implants for dealing with ischemic disease such as diabetic retinopathy. We also present data indicating that drift of the local pH of the oxygenated environment can be held constant using a feedback-controlled three electrode electrolysis system that chooses anode and cathode pair based on pH data provided by local microsensors. The work is discussed in the context of diabetic retinopathy since surgical techniques for multielectrode prosthetic implants aimed at retinal degenerative diseases have been developed.

  18. 培养于生物降解支架膜内的胚胎干细胞可修复小鼠的梗塞心肌%Embryonic stem cells cultured in biodegradable scaffold repair infarcted myocardium in mice

    Institute of Scientific and Technical Information of China (English)

    可庆恩; 杨寅柯; Jamal S.RANA; 陈玉; James P.MORGAN; 萧永福

    2005-01-01

    Our previous findings demonstrated that directly injecting embryonic stem cells (ESCs) into ischemic region of the heart improved cardiac function in animals with experimental myocardial infarction (MI). Tissue engineering with stem cells may provide tissue creation and repair. This study was designed to investigate the effectiveness of grafting of ESC-seeded biodegradable patch oninfarcted heart. MI in mice was induced by ligation of the left coronary artery. Mouse ESCs were seeded on polyglycolic-acid (PGA)material patches. Three days after culture, an ESC-seeded patch was transplanted on the surface of ischemic and peri-ischemic myocardium. Eight weeks after MI operation and patch transplantation, hemodynamics and cardiac function were evaluated in four (sham-operated, MI, MI + cell-free patch, and MI + ESC-patch) groups of mice. The blood pressure and left ventricular function were significantly reduced in the MI animals. Compared with MI alone and MI + cell-free patch groups, the animals Received MI + ESC seeded patches significantly improved blood pressure and ventricular function. The survival rate of the MI mice grafted with MI +ESC-seeded patches was markedly higher than that in MI alone or MI + cell-free patch animals. GFP-positive tissue was detected in infarcted area with grafting of ESC-seeded patch, which suggests the survivors of ESCs and possible myocardial regeneration. Our data demonstrate that grafting of ESC-seeded bioabsorbable patch can repair infarcted myocardium and improve cardiac function in MI mice. This novel approach of combining stem cells and biodegradable materials may provide a therapeutic modality for repairing injured heart.%我们以往的研究表明,直接在心肌梗塞(myocardialinfarction,MI)动物的心脏缺血区注射胚胎干细胞(embryonic stem cells,ESCs)可以提高其心肌功能,干细胞组织工程学可以使组织再生、修复.本研究旨在观察将ESCs接种到生物降解膜内并移植到梗塞部位

  19. Current status of percutaneous coronary intervention of chronic total occlusion

    Institute of Scientific and Technical Information of China (English)

    Jun-bo GE

    2012-01-01

    This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries.Chronic total occlusion is associated with 10%-20% of all PCI procedures.Results show that opening an occluded vessel,especially one supplying a considerable area of myocardium,may be beneficial for a patient's angina relief and heart function.We describe the devices used currently in re-canalization such as new wires,microcatheters (including Tonus and Cosair) and intravascular ultrasound guidance.Different techniques to improve the success rate and reduce complications are discussed in detail.

  20. Association of left ventricular mechanical dyssynchrony with survival benefit from revascularization: a study of gated positron emission tomography in patients with ischemic LV dysfunction and narrow QRS

    Energy Technology Data Exchange (ETDEWEB)

    AlJaroudi, Wael [Imaging Institute, Heart and Vascular, Cleveland, OH (United States); Sydell and Arnold Miller Family Heart and Vascular Institute, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland, OH (United States); Alraies, M.C. [Cleveland Clinic, Department of Hospital Medicine, Cleveland, OH (United States); Hachamovitch, Rory; Jaber, Wael A.; Brunken, Richard; Cerqueira, Manuel D.; Marwick, Thomas [Imaging Institute, Heart and Vascular, Cleveland, OH (United States)

    2012-10-15

    LV mechanical dyssynchrony (LVMD) is a risk marker in narrow QRS cardiomyopathy, but its association with treatment outcome is not well defined. We determined the incremental prognostic value of LVMD in ischemic cardiomyopathy, and assessed its interaction with scar, myocardium in jeopardy and subsequent revascularization. Stress and rest {sup 82}Rb gated PET were performed in 486 consecutive patients (66 {+-} 11 years of age, 82 % men, LV ejection fraction 26 {+-} 6 %) with ischemic cardiomyopathy and QRS <120 ms. LVMD was determined as the standard deviation (SD) of the regional time to minimum volume on phase analysis of the gated PET scan. A propensity score was determined to adjust for nonrandomized referral after imaging to coronary artery bypass grafting (CABG). In a Cox proportional hazards model used to determine the association between measures of LVMD and survival time, CABG was included as a time-dependent covariate and the use of an implantable cardiac defibrillator (ICD) after imaging was modeled as a stratification factor. Over 1.9 {+-} 1.4 years, 96 patients (20 %) underwent CABG and 108 (22 %) died. LVMD was a predictor of mortality (HR 1.16. 95 % CI 1.03;1.30, per 10 increase in phase SD, p = 0.02) after adjusting for baseline covariates, prior ICD use, the use of postimaging CABG, and other imaging data. There was a significant interaction between phase SD and CABG. Nested Cox models showed that LVMD carried prognostic information incremental to clinical variables, ejection fraction and CABG. LVMD is an independent predictor of all-cause mortality in ischemic cardiomyopathy, and may identify patients with a differential survival benefit from CABG versus medical therapy. (orig.)

  1. EFFECT OF DESTRUCTION OF NTS AND PVN ON NEIGUAN (PC 6)ELECTROACUPUNCTURE-INDUCED IMPROVEMENT OF ISCHEMIC MYOCARDIAL CELLULAR MEMBRANE POTENTIALS IN RABBITS

    Institute of Scientific and Technical Information of China (English)

    CHEN Ze-bin; WANG Shu-ju; WANG Ya-wen; WU Xu-ping; WANG Hua

    2005-01-01

    Objective:To observe the influence of electrolytic destruction of nucleus solitary tract (NTS) and hypothalamic paraventricular nucleus (PVN) on the effect of electroacupuncture (EA) in improving ischemic myocardia cellular transmembrane action potential (TMAP). Methods: 38 Japanese breed big-ear white rabbits (anesthetized with 20% Urethane, 4mL/kg) were randomly divided into acute myocardial ischemia (AMI) group (n=8), PVN destruction group (n=12) and PVN+NTS destruction group (n=18). AMI model was established by occlusion of the descending anterior branch (DAB) of the coronary artery. TMAP of myocytes was recorded by using a glass microelectrode which was fixed to a suspending spring silver wire. Bilateral "Neiguan"(PC 6) in all the 3 groups were punctured and stimulated electrically by using parameters of continuous waves, frequency ECG-ST elevated significantly while APA lowered, APD50 and APD90 shortened of 7 Hz, intensity of 6 mA and duration of 30 minutes. Results: After AMI,clearly in comparison with those of pre-AMI in the 3 groups. Compared with AMI group, ECG-ST values of PVN destruction group and PVN+NTS destruction group were significantly higher (P<0.05~0.01), while APA, APD50 and APD90 all significantly lower in all the recording time courses(P<0.05). The facts displayed that electrolytic destruction of PVN and PVN+NTS could produce ischemic myocardial injury and reduce the protective effect of EA on ischemic myocardial cells. Comparison between PVN destruction and PVN+NTS groups showed that all the 4 indexes of the later group were evidently worse than those of the former group (P<0.05), suggesting after destruction of these two nuclei, the effect of EA was worsened further. Conclusion: Electrolytic destruction of PVN and NTS weakens the protective effect of EA on ischemic myocardial cells, both NTS and PVN take part in the effect of EA of "Neiguan"(PC 6) Point in improving ischemic myocardium.

  2. Magnetic resonance hypointensive signal primarily originates from extracellular iron particles in the long-term tracking of mesenchymal stem cells transplanted in the infarcted myocardium

    Directory of Open Access Journals (Sweden)

    Huang Z

    2015-03-01

    Full Text Available Zheyong Huang,1,* Chenguang Li,1,* Shan Yang,2 Jianfeng Xu,1 Yunli Shen,3 Xinxing Xie,4 Yuxiang Dai,1 Hao Lu,1 Hui Gong,5 Aijun Sun,1 Juying Qian,1 Junbo Ge1 1Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 2Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 3Department of Cardiology, Shanghai East Hospital, Tongji University, Shanghai, People’s Republic of China; 4Department of Cardiology, Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, People’s Republic of China; 5Institute of Biomedical Science, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Purpose: The long-lasting hypointensities in cardiac magnetic resonance (CMR were believed to originate from superparamagnetic iron oxide (SPIO-engulfed macrophages during long-term stem cell tracking. However, the iron clearance capacity of the ischemic heart was limited. Therefore, we speculated that the extracellular SPIO particles may also be involved in the generation of false-positive signals.Methods and results: Male swine mesenchymal stem cells (MSCs were incubated with SPIO for 24 hours, and SPIO labeling had no significant effects on either cell viability or differentiation. In vitro studies showed that magnetic resonance failed to distinguish SPIO from living SPIO-MSCs or dead SPIO-MSCs. Two hours after the establishment of the female swine acute myocardial infarction model, 2×107 male SPIO-labeled MSCs (n=5 or unlabeled MSCs (n=5 were transextracardially injected into the infarcted myocardium at ten distinct sites. In vivo CMR with T2 star weighted imaging-flash-2D sequence revealed a signal void corresponding to the initial SPIO-MSC injection sites. At 6 months after transplantation, CMR identified 32 (64% of the 50 injection sites, where massive Prussian blue-positive iron

  3. In vitro cultured progenitors and precursors of cardiac cell lineages from human normal and post-ischemic hearts

    Directory of Open Access Journals (Sweden)

    F Di Meglio

    2009-08-01

    Full Text Available The demonstration of the presence of dividing primitive cells in damaged hearts has sparked increased interest about myocardium regenerative processes. We examined the rate and the differentiation of in vitro cultured resident cardiac primitive cells obtained from pathological and normal human hearts in order to evaluate the activation of progenitors and precursors of cardiac cell lineages in post-ischemic human hearts. The precursors and progenitors of cardiomyocyte, smooth muscle and endothelial lineage were identified by immunocytochemistry and the expression of characteristic markers was studied by western blot and RT-PCR. The amount of proteins characteristic for cardiac cells (a-SA and MHC, VEGFR-2 and FVIII, SMA for the precursors of cardiomyocytes, endothelial and smooth muscle cells, respectively inclines toward an increase in both a-SA and MHC. The increased levels of FVIII and VEGFR2 are statistically significant, suggesting an important re-activation of neoangiogenesis. At the same time, the augmented expression of mRNA for Nkx 2.5, the trascriptional factor for cardiomyocyte differentiation, confirms the persistence of differentiative processes in terminally injured hearts. Our study would appear to confirm the activation of human heart regeneration potential in pathological conditions and the ability of its primitive cells to maintain their proliferative capability in vitro. The cardiac cell isolation method we used could be useful in the future for studying modifications to the microenvironment that positively influence cardiac primitive cell differentiation or inhibit, or retard, the pathological remodeling and functional degradation of the heart.

  4. Dyslipidemia and Outcome in Patients with Acute Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    XU Tian; ZHANG Jin Tao; YANG Mei; ZHANG Huan; LIU Wen Qing; KONG Yan; XU Tan; ZHANG Yong Hong

    2014-01-01

    ObjectiveTo study the relationship between dyslipidemia and outcome in patients with acute ischemic stroke. MethodsData about 1 568 patients with acute ischemic stroke werecollected from 4 hospitals in Shandong Province from January 2006 to December 2008. National Institute of Health Stroke Scale (NIHSS) >10 at discharge or death was defined as the outcome. Effect of dyslipidemia on outcome in patients with acute ischemic stroke was analyzed by multivariate logistic regression analysis and propensity score-adjusted analysis, respectively. ResultsThe serum levels of TC, LDL-C, and HDL-C were significantly associated with the outcome in patients with acute ischemic stroke. Multivariate logistic regression analysis and propensity score-adjusted analysis showed that the ORs and 95% CIs were 3.013 (1.259, 7.214)/2.655 (1.298, 5.43), 3.157(1.306, 7.631)/3.405(1.621, 7.154), and 0.482 (0.245, 0.946)/0.51 (0.282, 0.921), respectively, for patients with acute ischemic stroke. Hosmer-Lemeshow goodness-of-fit test showed no significant difference in observed and predicted risk in patients with acute ischemic stroke (chi-square=8.235, P=0.411). ConclusionSerum levels of TC, LDL-C, and HDL-C are positively related with the outcome in patients with acute ischemic stroke.

  5. Predictors of ischemic versus hemorrhagic strokes in hypertensive patients

    International Nuclear Information System (INIS)

    Objective: To identify the factors that predispose to ischemic versus hemorrhagic stroke in hypertensive patients. Materials and Methods: All the hypertensive patients, who were registered in AKUH acute stroke outcome data base, over a period of 22 months, were identified and from this cohort the patients with first ever stroke were selected. The data regarding demographics, stroke type (ischemic vs. hemorrhagic), pre-existing medical problems, laboratory and radiological investigations was recorded and analyzed. Results: Five hundred and nineteen patients with either ischemic stroke or parenchymal hemorrhage were registered over a period of 22 months. Three hundred and forty-eight patients (67%) had hypertension and of these, 250 had first ever stroke at the time of admission. Presence of diabetes mellitus (OR: 3.76; Cl:1.67-8.46) and ischemic heart disease (OR: 6.97; Cl:1.57-30.98) were found to be independent predictors of ischemic strokes. Conclusion: Presence of diabetes mellitus and ischemic heart disease predict ischemic stroke in a patient with hypertension. (author)

  6. Correlation study on cystatin C and ischemic stroke

    Directory of Open Access Journals (Sweden)

    CHEN Rong-bo

    2013-06-01

    Full Text Available Objective To investigate the relationship between serum cystatin C (Cys C and patients with acute ischemic stroke. Methods The clinical and laboratory data of 115 patients with acute ischemic stroke and 110 controls were recorded and analyzed. Results The serum Cys C levels of patients in ischemic stroke group [(1.15 ± 0.34 mg/L] were higher than that of the control group [(0.99 ± 0.25 mg/L]. The difference between two groups was significant after correction of age and cardiovascular risk factors (t = ? 3.889, P = 0.000. It was found that age, Cys C, homocysteine (Hcy, type 2 diabetes mellitus [hemoglobin A1c (HbA1c, fructosamine (FRU], smoking, alcohol consumption, hypertension and intima-media thickness (IMT were risk factors for ischemic stroke on univariate Logistic regression analysis. The difference of serum Cys C level between the patients and controls was significant (P = 0.000, but through covariance analysis, after adjusted other risk factors, it was not significant (P = 0.875. Conclusion The serum Cys C levels of patients in ischemic stroke group is higher than the control group. It can be used as an indicator in the acute phase of ischemic stroke. The elevation of serum Cys C is a risk factor for ischemic stroke, but not an independent risk factor.

  7. Smoking Cessation Intervention After Ischemic Stroke or Transient Ischemic Attack. A Randomized Controlled Pilot Trial

    DEFF Research Database (Denmark)

    Brunner Frandsen, Nicole; Sørensen, Margit; Hyldahl, Tanja Kirstine;

    2012-01-01

    BACKGROUND: Smoking cessation is widely recommended for secondary stroke prevention. However, little is known about the efficacy of smoking cessation intervention after stroke or transient ischemic attack (TIA). METHODS: Ninety-four smokers under age 76, admitted with ischemic stroke or TIA were......-report and verified by measurement of exhaled carbon monoxide (CO). Fewer patients than expected were recruited, which renders this report a pilot study. RESULTS: The 6-month self-reported smoking cessation rate was 37.8% in the minimal intervention group and 42.9% in the intensive intervention group. Smoking...... randomized to minimal smoking cessation intervention or intensive smoking cessation intervention. All patients attended a 30-min individual counseling by the study nurse. Patients randomized to intensive smoking cessation intervention also participated in a 5-session outpatient smoking cessation program...

  8. Is opium addiction a risk factor for ischemic heart disease and ischemic stroke?

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Rezvani

    2012-01-01

    Full Text Available Background: The main source of studies about effects of opium consumption on heart and brain attacks originates from Iran Therefore the aim of the present study was to assess opium addiction as a probable influencing factor for ischemic heart disease and ischemic stroke. Materials and Methods: A cross-sectional study was carried out in two Cardiology and Neurology clinics in Eastern Iran in 2011. Diagnosis of Ischemic Heart Disease (IHD and Ischemic Stroke (IS was made by Cardiologist and Stroke Neurologist respectively. The influence of gender, hypertension, diabetes, hyperlipidemia, cigarette smoking, oral and inhaled opium consumption on distribution of IHD and IS were evaluated. Results: Five hundred fifty eight patients (307 females, 251 males with mean age 56.2 years enrolled the study. On adjusted odds ratios of our whole 558 patients, only hypertension and diabetes had a significant influence on occurrence of IHD; (P = 0.000 and P = 0.000 respectively. Oral and inhaled routes of opium addiction did not have a significant effect on occurrence of IHD; [OR = 1.172, 95% CI = 0.624-2.203, P = 0.621] and [OR = 1.820, 95% CI = 0.811-4.085, P = 0.147] respectively. Hypertension and diabetes were significant risk factors of IS in our 558 patients at multivariate analysis; (P = 0.000, P = 0.020. Oral opium addiction was as significant protective factor of IS in our study group; OR = 0.211, 95% CI = 0.079-0.564, P = 0.002, while inhaled opium addiction did not have a significant effect on occurrence of IS in our patients at; OR = 1.760, 95% CI = 0.760-4.076, P = 0.187. Conclusion: Oral opium consumption is a protective factor of IS but not IHD. Inhaled opium addiction does not have a significant influence on occur r ence of IS and IHD.

  9. Peculiarities of cardiac performance in children with bronchial asthma against chronic tonsillitis

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    Kondratiev V.А.

    2015-11-01

    Full Text Available A comparative assessment of cardiac performance by the data of clinical-instrumental examination of 50 patients aged 5-15 years with persisting form of partially-controlled atopic bronchial asthma in the period between the attacks of the disease was made. Children were divided into two groups depending on presence of concomitant chronic tonsillitis (18 patients or absence of the latter (32 patients. In all cases by the data of spirography in children against chronic tonsillitis in the period between the attacks of the disease there were revealed ventillation disorders in the lungs by obstruction type, this promoted elevation of pressure in the pulmonary artery. Only in this group of patients in 27,8% of cases pulmonary arterial hypertension of moderate severity was revealed. By echocardiography data in children with asthma against chronic tonsillitis reliably more often (р<0,01 there was revealed decrease of contractile function of myocardium of the left cardiac ventricle; this was caused by the presence of metabolic disturbances in the myocardium in the majority of cases (83,3%. These changes were registered on the electrocardiogram in the form of repolarisation changes of the ventricular complex. Presence of concomitant chronic tonsillitis in children with bronchial asthma favored formation of pulmonary hypertension on the one side and worsening of contractile ability of myocardium of the left cardiac ventricle on the other side; this required performing therapeutic-preventive measures for sanation of chronic infectious focus in the nasopharynx to prevent formation of chronic cardiac insufficiency during asthma course.

  10. Adiponectin, diabetes and ischemic heart failure: a challenging relationship

    Directory of Open Access Journals (Sweden)

    Baldasseroni Samuele

    2012-12-01

    Full Text Available Abstract Background Several peptides, named adipokines, are produced by the adipose tissue. Among those, adiponectin (AD is the most abundant. AD promotes peripheral insulin sensitivity, inhibits liver gluconeogenesis and displays anti-atherogenic and anti-inflammatory properties. Lower levels of AD are related to a higher risk of myocardial infarction and a worse prognosis in patients with coronary artery disease. However, despite a favorable clinical profile, AD increases in relation to worsening heart failure (HF; in this context, higher adiponectinemia is reliably related to poor prognosis. There is still little knowledge about how certain metabolic conditions, such as diabetes mellitus, modulate the relationship between AD and HF. We evaluated the level of adiponectin in patients with ischemic HF, with and without type 2 diabetes, to elucidate whether the metabolic syndrome was able to influence the relationship between AD and HF. Results We demonstrated that AD rises in patients with advanced HF, but to a lesser extent in diabetics than in non-diabetics. Diabetic patients with reduced systolic performance orchestrated a slower rise of AD which began only in face of overt HF. The different behavior of AD in the presence of diabetes was not entirely explained by differences in body mass index. In addition, NT-proBNP, the second strongest predictor of AD, did not differ significantly between diabetic and non-diabetic patients. These data indicate that some other mechanisms are involved in the regulation of AD in patients with type 2 diabetes and coronary artery disease. Conclusions AD rises across chronic heart failure stages but this phenomenon is less evident in type 2 diabetic patients. In the presence of diabetes, the progressive increase of AD in relation to the severity of LV dysfunction is hampered and becomes evident only in overt HF.

  11. A simplified technique for producing an ischemic wound model.

    Science.gov (United States)

    Chien, Sufan; Wilhelmi, Bradon J

    2012-01-01

    One major obstacle in current diabetic wound research is a lack of an ischemic wound model that can be safely used in diabetic animals. Drugs that work well in non-ischemic wounds may not work in human diabetic wounds because vasculopathy is one major factor that hinders healing of these wounds. We published an article in 2007 describing a rabbit ear ischemic wound model created by a minimally invasive surgical technique. Since then, we have further simplified the procedure for easier operation. On one ear, three small skin incisions were made on the vascular pedicles, 1-2 cm from the ear base. The central artery was ligated and cut along with the nerve. The whole cranial bundle was cut and ligated, leaving only the caudal branch intact. A circumferential subcutaneous tunnel was made through the incisions, to cut subcutaneous tissues, muscles, nerves, and small vessels. The other ear was used as a non-ischemic control. Four wounds were made on the ventral side of each ear. This technique produces 4 ischemic wounds and 4 non-ischemic wounds in one animal for paired comparisons. After surgery, the ischemic ear was cool and cyanotic, and showed reduced movement and a lack of pulse in the ear artery. Skin temperature of the ischemic ear was 1-10 °C lower than that on the normal ear and this difference was maintained for more than one month. Ear tissue high-energy phosphate contents were lower in the ischemic ear than the control ear. Wound healing times were longer in the ischemic ear than in the non-ischemic ear when the same treatment was used. The technique has now been used on more than 80 rabbits in which 23 were diabetic (diabetes time ranging from 2 weeks to 2 years). No single rabbit has developed any surgical complications such as bleeding, infection, or rupture in the skin incisions. The model has many advantages, such as little skin disruption, longer ischemic time, and higher success rate, when compared to many other models. It can be safely used in

  12. An update on brain imaging in transient ischemic attack.

    Science.gov (United States)

    Souillard-Scemama, R; Tisserand, M; Calvet, D; Jumadilova, D; Lion, S; Turc, G; Edjlali, M; Mellerio, C; Lamy, C; Naggara, O; Meder, J-F; Oppenheim, C

    2015-02-01

    Neuroimaging is critical in the evaluation of patients with transient ischemic attack (TIA) and MRI is the recommended modality to image an ischemic lesion. The presence of a diffusion (DWI) lesion in a patient with transient neurological symptoms confirms the vascular origin of the deficit and is predictive of a high risk of stroke. Refinement of MR studies including high resolution DWI and perfusion imaging using either MRI or CT further improve the detection of ischemic lesions. Rapid etiological work-up includes non-invasive imaging of cervical and intracranial arteries to search for symptomatic stenosis/occlusion associated with an increased risk of stroke.

  13. Citicoline for ischemic stroke: ICTUS trial

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2012-01-01

    Full Text Available The paper gives data available in the literature on the use of citicoline in an experimental model of ischemic stroke (IS and in randomized multicenter placebo-controlled trials. It analyzes the results of the ICTUS trial in which 2298 patients with IS who received randomly citicoline or placebo for 24 hours after the onset of symptoms (I000 mg intravenously every I2 hours during the first 3 days, then orally as one 500-mg tablet every 12 hours during 6 weeks. The results of the trial confirmed the safety of citicoline used in IS, but failed to show its significant advantage over placebo in reducing the degree of disability (global improvement 90 days later. However, to pool the results of the ICTUS trial with those of other randomized multicenter placebo-controlled studies demonstrates a significant decrease in the degree of disability in IS patients treated with citicoline.

  14. [Current registry studies of acute ischemic stroke].

    Science.gov (United States)

    Veltkamp, R; Jüttler, E; Pfefferkorn, T; Purrucker, J; Ringleb, P

    2012-10-01

    Study registries offer the opportunity to evaluate the effects of new therapies or to observe the consequences of new treatments in clinical practice. The SITS-MOST registry confirmed the validity of findings from randomized trials on intravenous thrombolysis concerning safety and efficacy in the clinical routine. Current study registries concerning new interventional thrombectomy techniques suggest a high recanalization rate; however, the clinical benefit can only be evaluated in randomized, controlled trials. Similarly, the experiences of the BASICS registry on basilar artery occlusion have led to the initiation of a controlled trial. The benefit of hemicraniectomy in malignant middle cerebral artery infarction has been demonstrated by the pooled analysis of three randomized trials. Numerous relevant aspects are currently documented in the DESTINY-R registry. Finally, the recently started RASUNOA registry examines diagnostic and therapeutic aspects of ischemic and hemorrhagic stroke occurring during therapy with new oral anticoagulants.

  15. [Ischemic stroke following a scorpion sting].

    Science.gov (United States)

    Elkhayari, M; Hachimi, A; Ziadi, A; Abdenasser Samkaoui, M

    2013-01-01

    Scorpion envenomation is caused by an accidental scorpion sting. In its severe form, it involves life-threatening respiratory or cardiac damage; it may also cause the neurological severity of systemic manifestations. We report the case of a young 35-year-old woman stung by an Androctonus mauretanicus scorpion, who developed impaired consciousness, hemiplegia and respiratory distress. At admission, the brain computed tomography showed a hypodense area in the right parietal region; the chest radiograph revealed a bilateral alveolar syndrome. Troponin was elevated and hemostasis disorders were present. The clinical course was remarkable: cardiogenic shock with multiple organ failure followed by death on day 3. This case illustrates a rare complication of scorpion envenomation: ischemic stroke due to an undetermined mechanism, which in addition to the cardiac and respiratory injuries, led to the serious complications and fatal outcome. PMID:23648127

  16. The effects of estrogen in ischemic stroke.

    Science.gov (United States)

    Koellhoffer, Edward C; McCullough, Louise D

    2013-08-01

    Stroke is a leading cause of death and the most common cause of long-term disability in the USA. Women have a lower incidence of stroke compared with men throughout most of the lifespan which has been ascribed to protective effects of gonadal steroids, most notably estrogen. Due to the lower stroke incidence observed in pre-menopausal women and robust preclinical evidence of neuroprotective and anti-inflammatory properties of estrogen, researchers have focused on the potential benefits of hormones to reduce ischemic brain injury. However, as women age, they are disproportionately affected by stroke, coincident with the loss of estrogen with menopause. The risk of stroke in elderly women exceeds that of men and it is clear that in some settings estrogen can have pro-inflammatory effects. This review will focus on estrogen and inflammation and its interaction with aging.

  17. Remote ischemic conditioning: Current clinical perspectives.

    Science.gov (United States)

    Le Page, Sophie; Prunier, Fabrice

    2015-08-01

    Remote ischemic conditioning (RIC) constitutes a promising method in which a tissue or organ is exposed to intermittent ischemia/reperfusion periods enabling it to provide protection to a distant target organ. RIC has been tested in various clinical settings through its simple application by means of intermittent inflation of a blood pressure cuff placed on a limb, primarily evaluating its potential abilities to decrease myocardial injury biomarkers. Its use on other organs, such as the kidneys or brain, has recently been a topic of research. To date, no study has yet been powerful enough to reach a conclusion on the potential benefit of RIC on clinical outcomes. The future role of RIC in the clinical arena could be clarified by the large phase III trials currently underway targeting major outcomes as primary endpoints.

  18. Pre-Ischemic Treadmill Training for Prevention of Ischemic Brain Injury via Regulation of Glutamate and Its Transporter GLT-1

    Directory of Open Access Journals (Sweden)

    Jingchun Guo

    2012-07-01

    Full Text Available Pre-ischemic treadmill training exerts cerebral protection in the prevention of cerebral ischemia by alleviating neurotoxicity induced by excessive glutamate release following ischemic stroke. However, the underlying mechanism of this process remains unclear. Cerebral ischemia-reperfusion injury was observed in a rat model after 2 weeks of pre-ischemic treadmill training. Cerebrospinal fluid was collected using the microdialysis sampling method, and the concentration of glutamate was determined every 40 min from the beginning of ischemia to 4 h after reperfusion with high-performance liquid chromatography (HPLC-fluorescence detection. At 3, 12, 24, and 48 h after ischemia, the expression of the glutamate transporter-1 (GLT-1 protein in brain tissues was determined by Western blot respectively. The effect of pre-ischemic treadmill training on glutamate concentration and GLT-1 expression after cerebral ischemia in rats along with changes in neurobehavioral score and cerebral infarct volume after 24 h ischemia yields critical information necessary to understand the protection mechanism exhibited by pre-ischemic treadmill training. The results demonstrated that pre-ischemic treadmill training up-regulates GLT-1 expression, decreases extracellular glutamate concentration, reduces cerebral infarct volume, and improves neurobehavioral score. Pre-ischemic treadmill training is likely to induce neuroprotection after cerebral ischemia by regulating GLT-1 expression, which results in re-uptake of excessive glutamate.

  19. Doença da discinesia miocárdica de estresse Myocardium stress diskinesia disease

    Directory of Open Access Journals (Sweden)

    Otoni Moreira Gomes

    2004-12-01

    Full Text Available OBJETIVO: Pesquisando a discinesia de contração miocárdica como outra possível causa da isquemia silenciosa de estresse, analisar a eficácia do cálcio inibidor miocítico diltiazem na normalização de testes ergométricos previamente positivos. MÉTODO: Em outubro de 2004, dez pacientes, sem sintomas de doença arterial coronária, com teste ergométrico positivo definido por infradesnível de segmento ST, sem dor precordial nem arritmia durante os exames (Seis - 60% - do sexo masculino; idades entre 42 e 71 anos, média de 58,2 anos, foram tratados com três doses diárias de 90mg de diltiazem e reestudados após período de cinco dias. Os exames foram realizados em esteira ergométrica, no protocolo de Bruce. RESULTADOS: O diltiazem impediu a depressão do segmento ST, tanto do ponto J (infradesnível médio e 2,1 ± 0,3mm, no controle, e 0,0 desnível com tratamento; p0,05. CONCLUSÃO: A administração do cálcio inibidor miocítico, diltiazem, impediu a depressão silenciosa do segmento ST previamente induzida por teste ergométrico em pacientes sem sintomas de doença arterial coronária, confirmando o envolvimento da discinesia da contração miocárdica na gênese do fenômeno.OBJECTIVE: To research the myocardium stress diskinesia as another possible cause of the silent myocardium ischemia induced by exercise testing stress and to analyze the efficacy of the myocytic calcium blocker diltiazem for normalization of previously positive testing. METHOD: In October 2004, ten patients without symptoms of coronary artery disease, presenting positive exercise testing, defined by ST segment depression, with neither precordial pain or arrhythmia during testing (six males - 60%; ages between 42 and 71 years old, mean 58.2 years, were treated with 90 mg of diltiazem in three times daily and re-studied five days after the first examination. Treadmill electrocardiography exercise testing was performed using the Bruce protocol. RESULTS

  20. Protective effects of ischemic postconditioning on intestinal

    Directory of Open Access Journals (Sweden)

    DING Jun-tao

    2011-04-01

    Full Text Available 【Abstract】Objective: To explore the protective effects of two types of ischemic postconditioning (IP on intestinal mucosa barrier in rabbits with crush injury of the hind limb. Methods: This study was conducted between August and December 2008 in the Department of Trauma Surgery, Daping Hospital, Third Military Medical University, Chongqing, China. The model of crush injury to the hind limb of rabbits was firstly developed by a 25 kg object with the right hind limbs fixed by wooden splints, and then two types of IP were established, including occluding/opening the common iliac artery and vein alternatively (traditional IP, IP A and binding/loosening the proximum of the injured hind limb alternatively (modified IP, IP B. Thirty-six male New Zealand white rabbits were randomly divided into three groups: IP A group, IP B group and control group, with 12 rabbits in each group. The serum levels of diamine oxidase (DAO and intestinal fatty acid-binding protein (I-FABP were detected at 2, 6, 12 and 24 hours after injury. Pathological changes of ileum were examined at 24 hours after injury. Results: The serum levels of I-FABP at 2, 6, 12 and 24 hours after injury in both IP A and IP B groups had a significant decrease, compared with control group. DAO levels also showed the same change trend at 2 and 6 hours after injury, but showed no significant difference between two IP groups. No difference in pathological changes of ileum was found among the three groups. Conclusions: IP can protect intestinal mucosa barrier function on the model of hind limb crush injury in rabbits. Meanwhile the modified IP B shows the same protection as the traditional IP A, and is worth applying in clinic. Key words: Ischemic postconditioning; Crush syndrome; Intestinal mucosa